Image-based surgical risk factors for Wilms tumor
Image-based surgical risk factors for Wilms tumor
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基于影像的肾母细胞瘤手术危险因素
DOI：
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
H. Okuyama
中科院分区：
文献类型：
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作者：
T. Oue;A. Yoneda;N. Usui;Takashi Sasaki;Masahiro Zenitani;N. Tanaka;S. Uehara;S. Ibuka;Y. Takama;H. Okuyama
目的肾母细胞瘤（Wilms tumor，WT）的标准治疗是一期切除。然而，在不可切除的肿瘤或肿瘤溢出的情况下，这被认为具有高手术风险，需要更密集的化疗和放疗。在本研究中，我们回顾性分析了术前图像参数，以确定与手术risk.MethodsTwenty-nine WT患者参加了这项研究的相关因素。收集各种术前影像学参数的数据，如肿瘤大小、肿瘤体积、大血管移位和肿瘤对侧延伸，以及它们与手术因素的关系，包括手术时间、出血、肿瘤溢出、结果肿瘤不能切除或有肿瘤溢出者，（手术高危组）更频繁地表现出大血管移位和对侧肿瘤扩展。手术时间和术中出血量与肿瘤大小、面积、体积、大血管移位和对侧侵犯有显著相关性。结论除肿瘤大小外，大血管移位和对侧侵犯也与手术风险有显著相关性。这些因素很容易确定使用CT图像，因此，是有用的，以决定是否术前化疗应开始，而不是原发性肿瘤切除术的大型局部WT。
PurposeThe standard treatment for Wilms tumor (WT) is primary resection. However, in cases with unresectable tumor or tumor spillage, which are considered to have high surgical risks, more intensive chemotherapy and radiotherapy are required. In the present study, we retrospectively analyzed preoperative image parameters to identify factors associated with surgical risks.MethodsTwenty-nine patients with WT were enrolled in this study. Data on various preoperative image parameters, such as tumor size, tumor volume, displacement of great vessels, and contralateral extension of the tumor were collected, and their relationship with surgical factors, including operative time, hemorrhage, tumor spillage, and unresectability were analyzed.ResultsPatients with unresectable tumor or with tumor spillage (surgical high-risk group) more frequently demonstrated displacement of great vessels and contralateral tumor extension. Operative time and blood loss were also significantly related to tumor size, area, volume, displacement of great vessels and contralateral extension.ConclusionBesides tumor size, displacement of great vessels and contralateral extension were significantly associated with surgical risks. These factors are easily determined using CT images and are, therefore, useful to decide whether preoperative chemotherapy should be started instead of primary tumor resection for large localized WTs.