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The prognostic significance of hypertension at diagnosis in children with wilms tumor.
- Source :
-
Saudi medical journal [Saudi Med J] 2017 Mar; Vol. 38 (3), pp. 262-267. - Publication Year :
- 2017
-
Abstract
- Objectives: To determine the prognostic effect of hypertension at diagnosis on outcomes of children with Wilms tumor (WT).   Methods: A single center retrospective analysis was conducted on 85 consecutive children with WT diagnosed between January 2000 and August 2013. Patients were classified as hypertensive or normotensive at diagnosis. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method. Cox regression was used to determine the predictive significance of hypertension and other clinical factors.  Results: Seventy-one patients had complete data. Of this, 25 (35.2%) were hypertensive and 46 (64.8%) normotensive with corresponding remission rates of 56.0% versus 82.6%, p=0.032; and death as first event of 7% versus 0%, p=0.004. The 5-year OS in the hypertensive versus normotensive patients were (67.1±10.3% versus 89.6±4.9%, p=0.009) and the corresponding 5-year PFS were (53.4±10.4% versus 79.1±6.2%, p=0.007). With univariate analysis, hypertension and local stage were predictors of OS (p=0.012 and p=0.029) and PFS (p=0.030 and p=0.008). In the multivariate analysis, hypertension, local stage, and histopathology were identified as independent prognostic factors of OS (p=0.004, p=0.034, and p=0.038); and hypertension  and local stage as prognostic for PFS (p=0.010 and p=0.012).  Conclusion: Hypertension at diagnosis is a prognostic predictor of poor outcome in WT and may signify tumor resistance.
- Subjects :
- Antineoplastic Agents
Child, Preschool
Comorbidity
Disease-Free Survival
Female
Humans
Kaplan-Meier Estimate
Kidney Neoplasms diagnosis
Kidney Neoplasms epidemiology
Kidney Neoplasms pathology
Male
Multivariate Analysis
Neoadjuvant Therapy
Neoplasm Staging
Nephrectomy
Prognosis
Proportional Hazards Models
Retrospective Studies
Survival Rate
Wilms Tumor diagnosis
Wilms Tumor epidemiology
Wilms Tumor pathology
Hypertension epidemiology
Kidney Neoplasms therapy
Wilms Tumor therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0379-5284
- Volume :
- 38
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Saudi medical journal
- Publication Type :
- Academic Journal
- Accession number :
- 28251221
- Full Text :
- https://doi.org/10.15537/smj.2017.3.15991