Correlation between post-chemotherapy tumor volume change on computed tomography and histopathological characteristics in patients with Wilms’ tumor
Main Article Content
Abstract
A retrospective study of 34 pediatric patients with Wilms’ tumor treated at the Vietnam National Children’s Hospital from 2022 to 2024 was conducted to evaluate the correlation between tumor volume change on CT (Volume Reduction Rate, VRR) and postoperative histopathological characteristics. Results showed a median tumor volume reduction of 35.7% and a median necrosis rate of 40.0%. There were significant differences among histopathological subtypes regarding VRR (p = 0.038) and the degree of necrosis (p < 0.001). The regressive type tended to show volume reduction accompanied by a high degree of necrosis. The stromal type recorded low levels of necrosis with little volume change or increase. In the completely necrotic group, the substantial increase in tumor volume was potentially due to intratumoral hemorrhage and liquefactive necrosis. Tumor volume changes on CT do not fully reflect the histologic response and should be interpreted cautiously alongside structural changes on imaging and the underlying histopathology.
Article Details
Keywords
Wilms' tumor, SIOP protocol, computed tomography, treatment response
References
2. Tran HD, Hoang, Ba X. Treatment of Nephroblastoma in Developing Countries - Experience from a Single Center in Vietnam with NWTS 5 and SIOP 2001 Protocols. Int J Cancer Clin Res. 2019;6(2):113. doi:10.23937/2378-3419/1410113
3. Vũ Trường Nhân. Vai trò của chụp cắt lớp vi tính trong điều trị bướu nguyên bào thận ở trẻ em với hóa trị tân bổ trợ. Tạp chí Y học cộng đồng. 2025;66(CĐ16-HNKH Bệnh viện Nhi Đồng 2). doi:10.52163/yhc.v66iCD16.3341
4. Benlhachemi S, Khattab M, Hattoufi K, et al. Impact of neoadjuvant chemotherapy on tumour volume in unilateral Wilms tumour histotypes: a retrospective study. BMC Cancer. 2025;25:1031. doi:10.1186/s12885-025-14177-x
5. Duncan C, Sarvode Mothi S, Santiago TC, et al. Response of bilateral Wilms tumor to chemotherapy suggests histologic subtype and guides treatment. J Natl Cancer Inst. 2024;116(8):1230-1237. doi:10.1093/jnci/djae072
6. Vũ Trường Nhân. Đặc điểm lâm sàng, cận lâm sàng và hình ảnh học trước - sau hoá trị tân bổ trợ ở bướu nguyên bào thận một bên có dấu hiệu xâm lấn tại Bệnh viện Nhi đồng 2. Tạp chí Nghiên cứu Y học. 2026;198(1):169-180. doi:10.52852/tcncyh.v198i1.4240
7. Bùi Ngọc Lan, Nghiêm Ngọc Linh. Kết quả điều trị u nguyên bào thận theo phác đồ SIOP tại Bệnh viện Nhi Trung ương. Tạp chí Nghiên cứu Y học. 2025;191(6):589-595. doi:10.52852/tcncyh.v19 1i6.3768
8. Nashat A, Alksas A, Aboulelkheir RT, et al. Artificial intelligence can help individualize Wilms tumor treatment by predicting tumor response to preoperative chemotherapy. Investig Clin Urol. 2025;66(1):47-55. doi:10.4111/icu.20240135
9. Theilen TM, Braun Y, Bochennek K, et al. Multidisciplinary Treatment Strategies for Wilms Tumor: Recent Advances, Technical Innovations and Future Directions. Front Pediatr. 2022;10:852185. doi:10.3389/fped.2022.852185
10. Graf N, Bergeron C, Brok J, et al. Fifty years of clinical and research studies for childhood renal tumors within the International Society of Pediatric Oncology (SIOP). Ann Oncol. 2021;32(11):1327-1331. doi:10.1016/j.annonc.2021.08.1749
11. Spreafico F, Fernandez CV, Brok J, et al. Wilms tumour. Nat Rev Dis Primers. 2021;7(1):75. doi:10.1038/s41572-021-00308-8
12. Vujanić GM, Gessler M, Ooms AHAG, et al. The UMBRELLA SIOP–RTSG 2016 Wilms tumour pathology and molecular biology protocol. Nat Rev Urol. 2018;15(11):693-701. doi:10.1038/s41585-018-0100-3
13. Milford K, DeCotiis K, Lorenzo A. Wilms tumor: a review of current surgical controversies. Translational Andrology and Urology. 2020;9(5):2382392-2382392. doi:10.21037/tau.2020.03.03
14. Boss MA, Malyarenko D, Partridge S, et al. The QIBA Profile for Diffusion-Weighted MRI: Apparent Diffusion Coefficient as a Quantitative Imaging Biomarker. Radiology. 2024;313(1):e233055. doi:10.1148/radiol.233 055