Maximizing lymph node retrieval during surgical resection of Wilms tumor.

Eur J Pediatr Surg

Department of Pediatric Surgery, Children's Hospital Colorado, Aurora, Colorado, United States.

Published: February 2015

Introduction: Sampling lymph nodes (LNs) is independently associated with decreased recurrence and improved survival for Wilms tumor (WT). Despite sampling, we noted cases where a few or no LNs were identified after resection of WT. We hypothesized fewer LNs were identified when submitted en bloc with the tumor, compared with when submitted separately.

Patients/materials And Methods: We conducted a retrospective chart review from 2003 to 2012 of WT resection cases, examining the type of LN dissection, the specimens submitted to pathology, number of LNs evaluated, and complications associated with the procedure.

Results: We identified 74 children with WT; 59 of 74 (79.7%) had unilateral disease and 15 of 74 (20.3%) had bilateral disease. With unilateral disease, more LNs were identified by separate versus en bloc sampling (5.2 ± 0.6 vs. 4.4 ± 1.2 nodes, p=0.61). Both the methods identified fewer LNs compared with en bloc+separate sampling (12.5 ± 2.7 nodes, p<0.001 and p=0.04, respectively). The majority of children with bilateral disease (10/15, 66.6%) did not have LN sampling intraoperatively. When submitted separately, 83.3 ± 3.8% of all LNs were identified in the separate specimen, and two en bloc specimens that were noted to have adenopathy intraoperatively had no LNs pathologically identified. Few cases had complications, which did not appear associated with LN sampling.

Conclusions: En bloc+separate sampling yields the most LNs during resection of WT. We recommend using this technique to facilitate the maximum number of LNs evaluated in WT. Low rates of LN sampling in bilateral disease may indicate decreased regard for sampling when tumor stage is already known.

Download full-text PDF

Source
http://dx.doi.org/10.1055/s-0034-1386637DOI Listing

Publication Analysis

Top Keywords

lns identified
12
wilms tumor
8
fewer lns
8
unilateral disease
8
lns
6
identified
5
maximizing lymph
4
lymph node
4
node retrieval
4
retrieval surgical
4

Similar Publications

Relationship Between Population Size and Habitat Area of Giant Pandas in China.

Animals (Basel)

January 2025

School of Ecology and Nature Conservation, Beijing Forestry University, Beijing 100083, China.

This study analyzed survey result data of giant panda populations and habitats in the third and fourth giant panda surveys to reveal the population size-habitat area relationship and assess the habitat status at the county and nature reserve levels. Results showed that a significant linear relationship existed between the logarithm of population size (lnS) and the logarithm of habitat area (lnA), with an equation of lnS = 1.145 × lnA - 4.

View Article and Find Full Text PDF

Improved diagnosis of small cervical lymph node metastasis using postvascular phase perfluorobutane CEUS in cancer patients.

BMC Cancer

January 2025

Department of Ultrasonography, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, 350014, China.

Background: Accurate identification of small metastatic lymph nodes (LNs) remains a significant challenge with conventional ultrasound (US) due to its limitations in sensitivity for smaller LNs. The use of contrast-enhanced ultrasound (CEUS), especially with perfluorobutane in the postvascular phase of CEUS, may improve the diagnosis of metastatic LNs in cancer patients. We sought to investigate the diagnostic accuracy of the postvascular phase of CEUS with perfluorobutane in identifying suspected small cervical LNs in cancer patients.

View Article and Find Full Text PDF

The current understanding of humoral immune response in cancer patients suggests that tumors may be infiltrated with diffuse B cells of extra-tumoral origin or may develop organized lymphoid structures, where somatic hypermutation and antigen-driven selection occur locally. These processes are believed to be significantly influenced by the tumor microenvironment through secretory factors and biased cell-cell interactions. To explore the manifestation of this influence, we used deep unbiased immunoglobulin profiling and systematically characterized the relationships between B cells in circulation, draining lymph nodes (draining LNs), and tumors in 14 patients with three human cancers.

View Article and Find Full Text PDF

Measuring working memory span with WAIS-IV: Digit sequence is the superior span test.

Appl Neuropsychol Adult

January 2025

Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.

The Digit Span test has been part of the Wechsler tests from the first version. In the WAIS-IV the Digit Span Sequencing subtest (DSS) was introduced and in the forthcoming WAIS-5 working memory span will also be measured in the visual modality. The present study analyzes WAIS-IV Digit Span, Letter- Number Span (LNS) and WMS-III Spatial Span (SS) performance in a mixed clinical sample, expecting to find that Digit Span Forwards (DSF) lacks sensitivity to the Working Memory impairment evident in D-KEFS Trail Making Test-4 (TMT-4) scores ≤1 SD below normative means in the sample.

View Article and Find Full Text PDF

Pollution, stress response, and obesity: A systematic review.

Obes Rev

January 2025

Inserm UMR 1256 Nutrition-Genetics-Environmental Risk Exposure (N-G-ERE), University of Lorraine, Nancy, France.

Limited literature addresses the association between pollution, stress, and obesity, and knowledge synthesis on the associations between these three topics has yet to be made. Two reviewers independently conducted a systematic review of MEDLINE, Embase, and Web of Science Core Collection databases to identify studies dealing with the effects of semi-volatile organic compounds, pesticides, conservatives, and heavy metals on the psychosocial stress response and adiposity in humans, animals, and cells. The quality of papers and risk assessment were evaluated with ToxRTool, BEES-C instrument score, SYRCLE's risk of bias tool, and CAMARADES checklist.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!