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

This is a retrospective study, for pediatric cases diagnosed as anaplastic Wilms' tumor treated at Children Cancer Hospital Egypt, 57357 (CCHE), from July 2007 to September 2017. All patients were reviewed for demographic profile, clinical features, imaging studies, treatment and outcome. Patients were treated according to modified COG protocol (AREN0321). Patients were followed up till January 2020. The aims of the study: to detect Outcome of anaplastic Wilms' Tumor in pediatric patients and different prognostic factors on outcome (age, stage, diffuse or focal anaplasia) and analysis of chemotherapy related toxicity. In 63 eligiable patients, median age was 4.5 years (range from 9 months to 12.5 years) with slight male predominance 54%. Abdominal mass was the commonest presentation. Twenty patients had metastatic disease 31.7% (n=20 patients), 19 patients had pulmonary metastasis only and one patient had combined pulmonary and hepatic metastases. All patients had anaplastic pathology. Twelve patients had focal anaplasia (19%) and 51 patients had diffuse anaplasia (81%). Stage III disease was the commonest 47.6% followed by stage IV (31.7%). Upfront nephrectomy was done in 18 patients while 45 patients received neoadjuvant chemotherapy.All patients received radiotherapy postoperative, the median time to start radiotherapy after surgery was 27 days. At the end of the study follow up period, five year OS and EFS were 70.7% and 68.1% respectively Recurrent episodes of fever neutropenia and cardiac toxicity were the most common treatment related toxicities among the cases of the study

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