Atin Singhai
King George’s Medical University, India
Title: Histological spectrum of neoadjuvant chemotherapy induced changes in childhood renal tumors as per SIOP protocol: A tertiary center experience
Biography
Biography: Atin Singhai
Abstract
International Society of Pediatric Oncology (SIOP) grading of childhood renal tumors receiving preoperative chemotherapy judiciously delineates subclasses and subgroups as per chemotherapy induced changes which further guides the clinicians for planning further course of management. A total of 32 cases were enrolled in our study, of which 23 received preoperative chemotherapy while 9 underwent upfront nephrectomy. All were clinico-radiologically suspicious for nephroblastoma however 4 turned out to have different histological diagnosis viz clear cell sarcoma of kidney (CCSK) in two and one each rhabdoid tumor and neuroblastoma respectively. All nine cases of upfront nephrectomy were histologically nephroblastoma and designated as controls. Significant response of epithelial and stromal elements to chemotherapy as per SIOP protocol was noted as against controls. However, blastoma predominant and diffuse anaplasia variants as well as other high risk tumors like CCSK, rhabdoid tumor and neuroblastoma had nil or minimal response and had to be considered for further chemotherapy. To conclude, management of childhood renal tumors especially nephroblastoma by SIOP protocol not only offers efficient reduction in viable tumor load but also demarcates high risk cases which require further chemotherapy.