儿童晚期肾母细胞瘤的术前化疗分析

目的探讨术前化疗对肿瘤较大或有远处转移的肾母细胞瘤的手术帮助和手术时机的选择。方法回顾性分析16例肾母细胞瘤的诊治过程。Ⅱ期10例，Ⅲ期5例，Ⅳ期1例。16例患儿术前均经影像学检查及穿刺活栓明确诊断。所有病例均予术前化疗后行手术治疗。结果5例瘤肾根治性切除，1例手术过程中发生肿瘤破裂，术后病理检查有镜下残留。在术前化疗后2～3周手术13例，2例因术前化疗后肿瘤坏死彻底未获得术后病理分型，术后化疗方案制定依据术前细针穿刺结果。结论术前化疗可以使肿瘤体积变小，减少肿瘤破溃，改善瘤体对毗邻器官浸润程度，使外科手术变得容易。

Analysis of Pre-operative Chemotherapy with Advanced Wilm's Tumor in Children

Objective The aim of this study was to evaluate the effect of pre - operative chemotherapy on the surgical resection of bulky or metastatic Wilm＇s tumor. Methods We retrospectively analyzed the process of diagnosis and treatment of 16 patients with pathologically confirmed Wilm＇s tumor. Of the 16 patients,10 had stage Ⅱ ,5 had stage Ⅲ and 1 had stage Ⅳ disease. All patients were treated by surgery after chemotherapy. Results Radical resection was successfully performed in 15 patients, and 1 patient had microscopic residual tumor duo to the tumor rupture during the surgical process. Surgical treatment was performed 2 to 3 weeks after the chemotherapy in 13 patients. 2 patients had pathological complete response. Conclusion Pre - operative chemotherapy could reduce the tumor volume, relieve the local invasion and facilitate the surgical treatment of patients with advanced Wilmg tumor.