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KMID : 0360319940260040631
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Journal of Korean Cancer Research Association
1994 Volume.26 No. 4 p.631 ~ p.636
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Preoperative Chemotherapy in Wilms Tumor
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유철주
김병수/정우회/서창옥/최승강/황의호
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Abstract
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From 1988, the use of preoperative chemotherapy for selected Wilms tumor was adopted at Yonsei Cancer Center. Between 1988 and 1992, 10 children has given preoperative chemotherapy. During that period, 21 children with Wilms tumor underwent
primary
nephrectomy(postoperative treatment group).
The criteria for preoperative chemotherapy were(a) initial surgical removal is excessively hazardous to patient (b) inoperable because of large size or extent of disease (c) patient with vena cava or atrial extension (d) radiologic evidence of
extensive
local invasion of adjacent organs or distant metastasis.
After preoperative treatment, the tumor size was markedly(>50%0 reduced in five patients. In all patients, nephrectomy was performed safely without rupture of tumor. Except stage IV patients, the downstaging may reduced the use of radiotherapy
during
adjuvant treatment. The 3-year survival rate for patients with preoperative chemotherapy was 80%. The survival of the preoperative chemotherapy group was similar to that in the postoperative treatment group(2-year survival rate; 80% vs 84%). But
there
was a higher rate of local recurrence in preoperative chemotherapy group.
We conclude that preoperative chemotherapy is the effective method of treatment in the selected cases of Wilms tumor.
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