UNASSIGNED: 8544 Background: This is a retrospective study of 140 @entity3969 @entity1 newly diagnosed and treated at the National @entity5 Institute between January 1991 and December 2000. The aim was to report results of combined modality treatment and to investigate the impact of biopsy, presence of blastema and preoperative chemotherapy on outcome Methods: Chemotherapy consisted of @entity1891 1.5mg/m(2) and @entity4316 45 g/kg for stage I and stage II favorable. @entity632 40mg/m(2) was added in alternation with @entity4316 to stage II unfavorable and stages III-V. Duration of therapy was 6 months for stage I and stage II favorable, 12 months for stages II unfavorable, III-V favorable and 18 months for stages III-V unfavorable. @entity5606 were given @entity2879 150mg/m(2)*3days and @entity3003 500mg/m(2) day1 alternating with @entity1260 1800mg/m(2)*5days and @entity632 75mg/m(2) day1. Postoperative radiotherapy was given to tumor-bed (10-27Gy) in stage II unfavorable, stages III-V and to metastatic lung site (12Gy). Preoperative chemotherapy was employed in @entity5 or presence of metastases Results: Using NWTS staging system 21.4%, 36.4%, 20.7%, 15.7% and 5.7% were stages I-V respectively. Histology was favorable (FH) in 93 (67%) @entity1 [31/93 showed blastema] and unfavorable (UH) in 46 (33%). Preoperative chemotherapy resulted in down staging of 30/54 (55.6%) @entity1 to stages I and II, of which only 4 relapsed. Local recurrence was reported in 4/32 @entity1 (12.5%) with core biopsy, 0/15 fine needle biopsy and 10/93 (10.75%) without biopsy. With median follow up of 63 months, overall 5-year survival and disease free survival (DFS) were 72.3  4% and 69  3.9% respectively. For FH, 5-year DFS was 78.2  4.3% [stages I-V being 92%, 74.3%, 74%, 60%, 80%] and 51.4  7.9% for UH (p= .0007, log rank test) [stages I-V being 75%, 72.7%, 63.6%, 8.3%, 33.3%] Within FH, 5-year DFS was 76.6% for blastema versus 83.3% for non blastema (p= .46, log rank) Conclusions: This study suggests that biopsy and down staging after preoperative chemotherapy did not lead to increased risk of recurrence. Presence of blastema had adverse impact on outcome; however it needs to be studied on larger scale No significant financial relationships to disclose.

Multidisciplinary Approach to XXXX : 10 Years Experience of NCI, Egypt.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity632 :: ('MESH:D004317', 'Chemical') :: ['Doxorubicin'] @entity5 :: ('MESH:D009369', 'Disease') :: ['massive or bilateral tumors', 'Cancer'] @entity3003 :: ('MESH:D016190', 'Chemical') :: ['Carboplatin'] @entity5606 :: ('MESH:D018335', 'Disease') :: ['Rhabdoid tumors'] @entity4316 :: ('MESH:D003609', 'Chemical') :: ['Actinomycin-D'] @entity2879 :: ('MESH:D005047', 'Chemical') :: ['Etoposide'] @entity1891 :: ('MESH:D014750', 'Chemical') :: ['Vincristine'] @entity1260 :: ('MESH:D007069', 'Chemical') :: ['Ifosfamide'] @entity3969 :: ('MESH:D009396', 'Disease') :: ['nephroblastoma']
@entity3969 :: (MESH:D009396,Disease) :: ['Wilms' Tumor']
