PMID- 1847966
OWN - NLM
STAT- MEDLINE
DCOM- 19910409
LR  - 20170210
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 9
IP  - 3
DP  - 1991 Mar
TI  - Percutaneous needle biopsy preceding preoperative chemotherapy in the management 
      of massive renal tumors in children.
PG  - 406-15
AB  - While the National Wilms' Tumor Study (NWTS) Group in the United States puts an 
      emphasis on accurate staging and histology before any therapy is given for Wilms' 
      tumor, the International Society of Pediatric Oncology (SIOP) in Europe focuses 
      on preoperative therapy and safer surgery. Our current approach combines the 
      benefits of both policies in the management of massive renal tumors in children. 
      In seven consecutive patients we first obtained a percutaneous posterior needle 
      biopsy to obtain adequate tissue for histology, and proceeded with preoperative 
      chemotherapy with vincristine and dactinomycin until tumor shrinkage was 
      sufficient. Tumor removals were feasible and uneventful. At the time of 
      operation, two tumors were found to be totally or almost totally necrotic. In the 
      others, which still included viable tumor, the histology corresponded well to the 
      needle biopsy findings. One case with unfavorable histology and one with rhabdoid 
      sarcoma would have been missed and given suboptimal therapy without the primary 
      needle biopsy. As possible biopsy-related complications, subcapsular intratumoral 
      bleeding was recognized in two patients. We conclude that percutaneous posterior 
      needle biopsy is safe and yields definite, detailed histology in massive renal 
      tumors in children. Preoperative chemotherapy facilitates surgery in these 
      patients.
FAU - Saarinen, U M
AU  - Saarinen UM
AD  - Children's Hospital, University of Helsinki, Finland.
FAU - Wikstrom, S
AU  - Wikstrom S
FAU - Koskimies, O
AU  - Koskimies O
FAU - Sariola, H
AU  - Sariola H
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/administration & 
      dosage/*therapeutic use
MH  - Biopsy, Needle
MH  - Child
MH  - Child, Preschool
MH  - Combined Modality Therapy
MH  - Female
MH  - Humans
MH  - Infant
MH  - Kidney Neoplasms/drug therapy/*pathology/surgery
MH  - Male
MH  - Postoperative Period
MH  - Premedication
MH  - Prognosis
MH  - Wilms Tumor/drug therapy/*pathology/surgery
EDAT- 1991/03/01 00:00
MHDA- 1991/03/01 00:01
CRDT- 1991/03/01 00:00
PHST- 1991/03/01 00:00 [pubmed]
PHST- 1991/03/01 00:01 [medline]
PHST- 1991/03/01 00:00 [entrez]
AID - 10.1200/JCO.1991.9.3.406 [doi]
PST - ppublish
SO  - J Clin Oncol. 1991 Mar;9(3):406-15. doi: 10.1200/JCO.1991.9.3.406.