Amos Loh1, Michael Bishop2, Matthew Krasin3, Andrew M Davidoff4, Max R Langham5. 1. Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN 38105, United States; Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore. 2. Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, United States. 3. Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, TN 38105, United States. 4. Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN 38105, United States; Department of Surgery, The University of Tennessee Health Science Center, Memphis, TN 38103, United States. 5. Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN 38105, United States; Department of Surgery, The University of Tennessee Health Science Center, Memphis, TN 38103, United States; Division of Pediatric Surgery, Le Bonheur Children's Hospital, Memphis, TN 38103, United States. Electronic address: mlangham@uthsc.edu.
Abstract
BACKGROUND: The long-term physiologic and oncologic outcomes of treatment for inferior vena cava (IVC) thrombosis in children with malignant abdominal tumors are unclear. METHODS: We conducted a retrospective review of children with malignant IVC tumor thrombosis treated at our institution between January 1996 and December 2011. Extent of tumor thrombus was classified using the Hinman system. Disease stage, management, and oncologic and physiologic outcomes and complications were evaluated. RESULTS: We identified 15 patients (median age, 4.7 years): 12 with Wilms tumor, 2 with hepatoblastoma, and 1 with adrenocortical carcinoma. Neoadjuvant chemotherapy changed Hinman levels in 2 (13%) patients. IVC thrombus resection was complete in 6 (40%) patients, partial in 7 (47%) patients, and not performed in 1 (6.7%) patient. On follow-up imaging, 8 (53%) patients' IVCs were patent, 6 (40%) had residual thrombus, and 1 (6.7%) was surgically interrupted. Three (20%) patients had perioperative complications, and 2 (13%) experienced transient effects related to IVC occlusion. CONCLUSIONS: Surgical management of tumor thrombus in the vena cava of children with solid abdominal tumors is challenging. Evidence on which to base strong treatment recommendations is lacking. Few long-term physiologic complications were observed.
BACKGROUND: The long-term physiologic and oncologic outcomes of treatment for inferior vena cava (IVC) thrombosis in children with malignant abdominal tumors are unclear. METHODS: We conducted a retrospective review of children with malignant IVC tumor thrombosis treated at our institution between January 1996 and December 2011. Extent of tumor thrombus was classified using the Hinman system. Disease stage, management, and oncologic and physiologic outcomes and complications were evaluated. RESULTS: We identified 15 patients (median age, 4.7 years): 12 with Wilms tumor, 2 with hepatoblastoma, and 1 with adrenocortical carcinoma. Neoadjuvant chemotherapy changed Hinman levels in 2 (13%) patients. IVC thrombus resection was complete in 6 (40%) patients, partial in 7 (47%) patients, and not performed in 1 (6.7%) patient. On follow-up imaging, 8 (53%) patients' IVCs were patent, 6 (40%) had residual thrombus, and 1 (6.7%) was surgically interrupted. Three (20%) patients had perioperative complications, and 2 (13%) experienced transient effects related to IVC occlusion. CONCLUSIONS: Surgical management of tumor thrombus in the vena cava of children with solid abdominal tumors is challenging. Evidence on which to base strong treatment recommendations is lacking. Few long-term physiologic complications were observed.
Authors: Simone de Campos Vieira Abib; Chan Hon Chui; Sharon Cox; Abdelhafeez H Abdelhafeez; Israel Fernandez-Pineda; Ahmed Elgendy; Jonathan Karpelowsky; Pablo Lobos; Marc Wijnen; Jörg Fuchs; Andrea Hayes; Justin T Gerstle Journal: Ecancermedicalscience Date: 2022-02-17
Authors: Mayara Caroline Amorim Fanelli; José Cícero Stocco Guilhen; Alexandre Alberto Barros Duarte; Fernanda Kelly Marques de Souza; Monica Dos Santos Cypriano; Eliana Maria Monteiro Caran; Henrique Manoel Lederman; Maria Teresa de Seixas Alves; Simone de Campos Vieira Abib Journal: Front Pediatr Date: 2022-01-04 Impact factor: 3.418