PMID- 28983345
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 1920-4531 (Print)
IS  - 1920-454X (Electronic)
IS  - 1920-4531 (Linking)
VI  - 6
IP  - 5
DP  - 2015 Oct
TI  - Initial Surgery in Tailoring Treatment for Children With Stage II and III Wilms' 
      Tumor: An Experience From Resource Challenged Settings.
PG  - 441-445
LID - 10.14740/wjon876w [doi]
AB  - BACKGROUND: Although Wilms' tumor (WT) is ranked first among primary childhood's 
      renal neoplasm, controversy still exists regarding the best approach for its 
      management. The study aimed at evaluating the role of initial surgery in 
      treatment of stage II and III pediatric WT as a part of the short administration 
      schedule as in National Wilms' Tumor Study (NWTS)-4 and evaluating its 
      effectiveness compared to the long administration schedule. METHODS: The study 
      included 30 children who were primarily diagnosed as stage II and III WT. They 
      were divided into two equal groups. Group I (n = 15) included those children who 
      had undergone neoadjuvant chemotherapy followed by surgery and postoperative 
      chemotherapy, while group II (n = 15) included those children who had undergone 
      primary surgery as an initial management followed by chemotherapy. After a mean 
      postoperative follow-up period of 14 +/- 5 months, clinical and radiological 
      evaluation was performed to all patients. RESULTS: In group I, 10 patients were 
      preoperatively diagnosed as stage II and five patients as stage III while in 
      group II, 11 patients were proved to be stage II and four patients were stage 
      III. After a follow-up period, clinical and radiological evaluation using CT was 
      performed to all patients. In patients with stage II, evidence of recurrence was 
      noted in three patients of group I whereas no patient showed any evidence of 
      recurrence in group II. In patients with stage III, rebound increase in size was 
      seen in two patients in group I and only one patient in group II. CONCLUSIONS: 
      Initial surgical intervention with appropriate adjuvant therapy has better 
      outcomes than the neoadjuvant chemotherapy and delayed surgery for children 
      primarily diagnosed as stage II and III WT. Moreover, it may act as a short 
      administration schedule for the treatment as it is not less effective than the 
      long administration schedule and can be administered at a substantially lower 
      total treatment cost.
FAU - Zakaria, Ossama M
AU  - Zakaria OM
AD  - Department of Surgery, College of Medicine, King Faisal University, Al Ahsa, KSA.
AD  - Department of Surgery, College of Medicine, Dammam University, KSA.
FAU - Hokkam, Emad N
AU  - Hokkam EN
AD  - Department of Surgery, Faculty of Medicine, Suez Canal University, Egypt.
FAU - Sayem, Karam Al
AU  - Sayem KA
AD  - Department of Surgery, Faculty of Medicine, Suez Canal University, Egypt.
FAU - Daoud, Mohamed Yasser I
AU  - Daoud MYI
AD  - Department of Surgery, College of Medicine, King Faisal University, Al Ahsa, KSA.
FAU - Zakaria, Hazem M
AU  - Zakaria HM
AD  - Department of Surgery, College of Medicine, Dammam University, KSA.
FAU - Sedky, Fouad
AU  - Sedky F
AD  - Department of Surgery, College of Medicine, Dammam University, KSA.
FAU - Graiz, Seba H
AU  - Graiz SH
AD  - Department of Surgery, College of Medicine, King Faisal University, Al Ahsa, KSA.
FAU - Moussa, Saleh A
AU  - Moussa SA
AD  - Prince Saud bin Jalawi Hospital, MOH, Al Ahsa, KSA.
FAU - Wadaani, Hamed A Al
AU  - Wadaani HAA
AD  - Department of Surgery, College of Medicine, King Faisal University, Al Ahsa, KSA.
LA  - eng
PT  - Journal Article
DEP - 20151026
PL  - Canada
TA  - World J Oncol
JT  - World journal of oncology
JID - 101564097
PMC - PMC5624669
OTO - NOTNLM
OT  - Chemotherapy and surgery
OT  - Children
OT  - Cost-effectiveness
OT  - Resource challenged settings
OT  - Wilms' tumor
COIS- The authors declare that there is no conflict of interests regarding the 
      publication of this article.
EDAT- 2015/10/01 00:00
MHDA- 2015/10/01 00:01
PMCR- 2015/10/01
CRDT- 2017/10/07 06:00
PHST- 2015/01/19 00:00 [accepted]
PHST- 2017/10/07 06:00 [entrez]
PHST- 2015/10/01 00:00 [pubmed]
PHST- 2015/10/01 00:01 [medline]
PHST- 2015/10/01 00:00 [pmc-release]
AID - 10.14740/wjon876w [doi]
PST - ppublish
SO  - World J Oncol. 2015 Oct;6(5):441-445. doi: 10.14740/wjon876w. Epub 2015 Oct 26.