Use of Palliative Site-Directed Ablation in Pediatric Oncology: A Retrospective Study From the Pediatric Surgical Oncology Research Collaborative.

Background: Children with end-stage solid tumors would benefit from established nonsurgical options for palliative site-directed local control with the intent of improving quality of life (QOL) and extending survival. We investigated the practice and tolerability of palliative ablation strategies in patients with pediatric solid tumors.

Methods: Children and young adults with solid tumors ineligible for surgical site-directed control were treated with palliative ablative strategies between 2010 and 2020 at five institutions participating in the Pediatric Surgical Oncology Research Collaborative.

Perioperative Antibiotic Use in Pediatric Solid Tumor Resection: A Two-center Retrospective Cohort Study.

Purpose: There is no consensus on the perioperative use of antibiotics in pediatric solid tumor resection. This study collected data from two pediatric centers that utilize perioperative antibiotics to varying degrees in pediatric solid tumor patients to investigate the occurrence of postoperative sepsis and infectious complications.

Methods: A two-institution, retrospective cohort study was performed.

Adherence outcomes of a liquid hydroxyurea delivery program in a pediatric population.

Background: Hydroxyurea remains underutilized in the pediatric sickle cell population despite its well-known efficacy in decreasing sickle cell complications and hospitalizations. Access to refills and liquid formulation remains a critical barrier to adherence to hydroxyurea regimens. This study was undertaken to determine the clinical impact of home-delivering compounded liquid hydroxyurea (LHU) to pediatric patients with sickle cell disease.

Evaluation of Bayesian point-based system on the variant classification of hereditary cancer predisposition genes.

Purpose: To assess the differences in variant classifications using the American College of Medical Genetics and Genomics and the Association for Molecular Pathology 2015 guidelines and the Bayesian point-based classification system (here referred to as the point system) in 115 hereditary cancer predisposition genes and explore variant sub-tiering by the point system.

Methods: Germline variant classifications for 721 pediatric patients from an in-house panel were retrospectively evaluated using the 2 scoring systems.

Results: A total of 2376 unique variants were identified, with ∼23.

Outpatient Pediatric Palliative Care Development: Guidance on Building Sustainable Programs.

As pediatric palliative care (PPC) expands within institutions and nationally, little guidance is available on building outpatient programs. We asked outpatient PPC (OPPC) program leaders in the United States about clinic development experiences to gather advice for growing programs. As part of a larger OPPC study, 48 freestanding children's hospitals with inpatient PPC programs were invited to complete a survey on OPPC.

Utilization of Palliative Radiation in Pediatric Oncology Patients During the End-of-Life (EOL).

Background: Suffering at the end-of-life (EOL) can impact the perception of a "good death" and ultimately affect bereavement for families of children with cancer. Palliative radiation (pXRT) is a tool that can address pain, mitigate suffering and improve quality of life.

Methods: A retrospective medical record review of pediatric oncology patients who died over an 11-year period was completed.

Response of bilateral Wilms tumor to chemotherapy suggests histologic subtype and guides treatment.

Background: Patients with bilateral Wilms tumor initially receive neoadjuvant chemotherapy to shrink the tumors and increase the likelihood of successful nephron-sparing surgery. Biopsy of poorly responding tumors is often done to better understand therapy resistance. The purpose of this retrospective, single-institution study was to determine whether initial chemotherapy response is associated with tumor histology, potentially obviating the need for biopsy or change in chemotherapy.

Longitudinal clinical data improve survival prediction after hematopoietic cell transplantation using machine learning.

Serial prognostic evaluation after allogeneic hematopoietic cell transplantation (allo-HCT) might help identify patients at high risk of lethal organ dysfunction. Current prediction algorithms based on models that do not incorporate changes to patients' clinical condition after allo-HCT have limited predictive ability. We developed and validated a robust risk-prediction algorithm to predict short- and long-term survival after allo-HCT in pediatric patients that includes baseline biological variables and changes in the patients' clinical status after allo-HCT.

Retroperitoneoscopic or Transperitoneal Approach for Neurogenic and Adrenal Tumors in Children? A Comparison on the Way to Enhanced Recovery in Pediatric Surgical Oncology.

Background: Minimally invasive surgery is increasingly utilized for resection of neurogenic tumors in children. The minimally invasive retroperitoneoscopic approach was recently reported in children, but transperitoneal laparoscopy still remains the most common technique. The aim of this study is to compare a novel single-port retroperitoneoscopy (SPR) approach for pediatric neurogenic tumor resection with transperitoneal laparoscopic (TPL).

Integration of Palliative Care in Hematopoietic Cell Transplant: Pediatric Patient and Parent Needs and Attitudes.

Context: Early integration of palliative care (PC) in hematopoietic cell transplantation (HCT) has demonstrated benefits, yet barriers remain, including perceived lack of patient/caregiver receptivity despite no data on attitudes toward PC and limited patient/caregiver reported outcomes in pediatric HCT.

Objectives: This study aimed to evaluate perceived symptom burden and patient/parent attitudes toward early PC integration in pediatric HCT.

Methods: Following IRB approval, consent/assent, eligible participants were surveyed at St.

Feasibility of indocyanine green-guided localization of pulmonary nodules in children with solid tumors.

Background: Clearing all pulmonary metastases is essential for curing pediatric solid tumors. However, intraoperative localization of such pulmonary nodules can be challenging. Therefore, an intraoperative tool that localizes pulmonary metastases is needed to improve diagnostic and therapeutic resections.

Aggressive Pursuit of No Evidence of Disease Status in Hepatoblastoma Improves Survival: An Observational Study.

Background: The utility of repeated surgical interventions in hepatoblastoma to achieve no evidence of disease (NED) is not well-defined. We examined the effect of aggressive pursuit of NED status on event-free (EFS) and overall survival (OS) in hepatoblastoma with subgroup analysis of high-risk patients.

Methods: Hospital records were queried for patients with hepatoblastoma from 2005 to 2021.

The Landscape of Outpatient Pediatric Palliative Care: A National Cross-Sectional Assessment.

Context: Inpatient pediatric palliative care (PPC) has grown substantially over the past 20 years; however, PPC in the outpatient setting remains underdeveloped. Outpatient PPC (OPPC) offers opportunities to improve access to PPC as well as facilitate care coordination and transitions for children with serious illness.

Objectives: This study aimed to characterize the national status of OPPC programmatic development and operationalization in the United States.

Associations of Iron Sucrose and Intradialytic Blood Pressure.

Rationale & Objective: Intradialytic hypotension and intradialytic hypertension are associated with morbidity and mortality in hemodialysis (HD). Many factors can contribute to intra-HD blood pressure (BP) changes, such as drugs with vasoactive properties that can destabilize an already tenuous BP. Intravenous iron sucrose is commonly administered to correct iron deficiency; however, its reported associations with altered hemodynamics have not been consistent.

The Kidney Failure Risk Equation Score and CKD Care Delivery Measures: A Cross-sectional Study.

Rationale & Objective: The 4-variable kidney failure risk equation (KFRE) allows for the prediction of chronic kidney disease (CKD) progression using age, sex, estimated glomerular filtration rate, and urine albumin/creatinine ratio. Electronic health records enable KFRE auto-calculation, and registries allow population-level application. We assessed whether 2-year KFRE score categories are associated with CKD care metrics.

Clinical Trial Enrollment Among Adolescent and Young Adults with Primary Central Nervous System Tumors Treated at the Dana-Farber Cancer Institute.

In recent decades, the survival outcomes among adolescent and young adults (AYAs, 15-39 years) have not improved substantially, especially among AYAs with primary central nervous system (CNS) tumors. While this is likely multifactorial, low participation in clinical trials among AYAs is thought to be a critical contributing factor. In this study, we describe the pattern of clinical trial enrollment among AYAs with primary CNS tumors at our institution.

Circulating Plasma Biomarkers in Biopsy-Confirmed Kidney Disease.

Background And Objectives: Biomarkers for noninvasive assessment of histopathology and prognosis are needed in patients with kidney disease.

Design, Setting, Participants, & Measurements: Using a proteomics assay, we measured a multimarker panel of 225 circulating plasma proteins in a prospective cohort study of 549 individuals with biopsy-confirmed kidney diseases and semiquantitative assessment of histopathology. We tested the associations of each biomarker with histopathologic lesions and the risks of kidney disease progression (defined as ≥40% decline in eGFR or initiation of KRT) and death.

Endothelin-1 and Parameters of Systolic Blood Pressure in Hemodialysis.

Background: Hypertension is common in hemodialysis (HD) patients. Increased blood pressure (BP) variability, particularly higher and lower extremes, is associated with adverse outcomes. We explored the association of endothelin-1 (ET-1), a potent vasoconstrictor, with different BP parameters (pre-HD, intra-HD, and post-HD) during HD in a contemporary patient cohort.