Thesis (M.Sc.) - Cairo University - National Cancer Institute - Department of Pediatric Oncology

Background: Malignant renal tumors account for 7% of childhood cancers and Wilms{u2019} tumor is by far the most common renal neoplasm in the pediatric population. However, the majority of these tumors are diagnosed before the patient is aged 5 years, it is now believed that renal tumors in older children differ from their counterparts in young patients in clinical behavior, biology, histology, and the long term outcome. In particular, renal cell carcinoma, primitive neuroectodermal tumor, anaplastic Wilms{u2019} tumors, and primary renal synovial sarcoma are relatively more frequent in older children and adolescents. Among children above 5 years, a poorer prognosis has been associated with a higher prevalence of unfavorable histology, advanced disease stage and different aggressive tumor types. Purpose: The aim of this study is to analyze different aspects of renal tumors in children aged above 5 years, and to compare the disease characteristics, treatment approach and outcome with the previously published literature. Methods: This is a retrospective study included pediatric patients aged 5-18 years diagnosed with primary renal tumors, treated at NCI, between January 2008 and December 2017. Medical records of all patients were reviewed for demographic profile, clinical features, imaging studies, management and treatment outcome. Patients were followed up till December 2018. Results: There were 47 patients (20%) with renal tumors in children aged 5-18 years, with the majority of them aged below 10 years (80%). Wilms{u2019} tumor is the most common histology (80.9%) but only nine patients had non-Wilms{u2019} tumors (19%), most of the Wilms{u2019} tumor cases had favorable histology (FH) (87%),and only five patients had unfavorable histology (13%). Among the Non-Wilms{u2019} tumors, Renal cell carcinoma (RCC), clear cell sarcoma, Primitive neuroectodermal tumor (PNET) and synovial sarcoma were found in two cases for each one (4.3% for each type), and one case of undifferentiated sarcoma (2.1%)

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