ESPU Congress 2018 - Abstract Book

109

11–14 APRIL, 2018, HELSINKI, FINLAND

08:09–08:12

S13-4 (PP)

PULMONARY METASTASES AND WILMS' TUMOR

HISTOPATHOLOGY, AN ASSOCIATION?

Seppo TASKINEN

, Minna KOSKENVUO

, Jouko LOHI

, Outi LESKINEN

and Mervi

TASKINEN

1) Helsinki University Hospital, Paediatric surgery, Helsinki, FINLAND - 2) Helsinki University Hospital, Pediatric

Hematology/Oncology and Stem Cell Transplantation, Helsinki, FINLAND - 3) Helsinki University Hospital, Pathology,

Helsinki, FINLAND - 4) Helsinki University Hospital, Radiology, Helsinki, FINLAND

PURPOSE

To evaluate if Wilms’ tumor histopathology is different in patients with and without pulmonary

metastases.

MATERIAL AND METHODS

Operative database was evaluated for Wilms’ tumors during years 1988–2015. Pathology sam-

ples were re-evaluated from all 59 patients who had diagnostic cutting needle biopsy (CNB) and

nephrectomy samples after neoadjuvant chemotherapy available. Tumor volumes at diagnosis and

preoperatively were measured from all 52 patients, who had CT- or MRI-images available for re-

evaluation. Pulmonary metastases were diagnosed by CT scan.

RESULTS

Fifteen out of the 59 (25 %) patients had pulmonary metastases in CT-scans. Radiological Wilms’

tumor volume and CNB blastemal cell proportion were usually higher in patients with pulmonary

metastases (903 ml (IQR 807–1215) vs. non-metastatic 428 ml (IQR 299–765), p<0.001) and

75 % (IQR 50–97) vs. 50 % (IQR 20–80), p=0.025 respectively). The proportions of stromal and

epithelial cells were similar between those with and without metastases (p=0.229 and 0.257 re-

spectively). Nephrectomy samples belonged to low risk, intermediate risk and high risk in 5 (11 %),

33 (75 %) and 6 (14 %) patients without pulmonary metastases and in 1 (7 %), 13 (87 %) and

1 (7 %) patients with pulmonary metastases respectively. At nephrectomy samples, the proportion

of necrosis was bigger in patients with than without metastases (95 % (IQR76–99) vs. 60 % (IQR

20–96), p=0.033 respectively). In 12/15 cases the pulmonary metastases disappeared during

preoperative chemotherapy, with no difference in Wilms’ tumor histopathology between the cases

with responding or resistant metastases.

CONCLUSIONS

Large-volume blastemal-rich Wilms’ tumors are most prone to present with pulmonary metastases.

80 % of pulmonary metastases disappear with preoperative chemotherapy.

08:12–08:24

Discussion