A 25-year experience with renal tumors of childhood.

Abstract:

:A retrospective analysis of the medical records of 234 children with renal tumors managed over a 25-year period at the Children's Memorial Medical Center was undertaken to evaluate long-term morbidity and mortality. There was a significant increase in survival over the years of the study. The 5-year survival for patients treated during the period 1985 to 1989 was 94% versus 68% for the period 1965 to 1969. Thirty-three children have died, 15 with known disease progression. Long-term morbidity included scoliosis (39), cardiorespiratory insufficiency (13), hypertension (7), renal insufficiency (7), small bowel obstruction (10), chest wall deformity (3), amenorrhea (1), leg length discrepancy (1), and 1 patient with an esophageal stricture. One patient with cardiomyopathy secondary to adriamycin has recently undergone cardiac transplantation. Five patients with renal insufficiency have required dialysis. Of these five, one patient has had two renal transplants. The presence of distant metastases and positive hilar or regional lymph nodes were the only findings at operation that were associated with an increased mortality (P = .005). There was a significantly increased mortality in those children operated on by general surgeons or urologists at other hospitals (11/43) versus those operated upon at our hospital (22/191) (P = .033). There was no statistical difference in the staging or histology among these children. We feel that the careful and systematic approach of a radical nephrectomy assures accurate staging of the tumor removing gross and microscopic disease in the abdomen.

journal_name

J Pediatr Surg

authors

Cosentino CM,Raffensperger JG,Luck SR,Reynolds M,Sherman JO,Reyes-Mugica M

doi

10.1016/s0022-3468(05)80326-4

subject

Has Abstract

pub_date

1993-10-01 00:00:00

pages

1350-4; discussion 1354-5

issue

10

eissn

0022-3468

issn

1531-5037

pii

S0022346893000491

journal_volume

28

pub_type

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