Effect of Wilms tumor histology on response to neoadjuvant chemotherapy

Purpose

To evaluate the association between Wilms tumor histology at diagnosis and the change in Wilms' tumor volume during preoperative chemotherapy.

Methods

We included all the 52 patients operated for Wilms tumor at 1988–2015, who had both pathology samples and either CT or MRI-images before and after preoperative chemotherapy, available for reevaluation.

Results

The median tumor volume was 586?ml (IQR 323–903) at diagnosis. The median change in tumor volume was ? 68% (IQR ? 85 to ? 40, p? 0.452, p?=?0.002). High stromal and epithelial cell contents in CNB samples were associated with the lesser change in tumor volume (Rho?=?0.279, p? =0.053 and Rho?=?0.300, p?=?0.038 respectively). Reduction of tumor volume and the proportion of tumor necrosis after chemotherapy were associated (Rho?=?? 0.502, p?

Conclusion

Wilms tumor total and viable tumor volumes were reduced by 68% and 97% with preoperative chemotherapy, respectively. High proportion of blastemal cells in CNB was associated with greatest decrease in Wilms tumor volume. Increase in tumor volume during preoperative chemotherapy may indicate anaplastic tumor and prolonging of preoperative therapy should be avoided.

Type of study

Retrospective review.

Level of evidence

Level III.