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Association of Paediatric Surgeons of Bangladesh
Journal of Paediatric Surgeons of Bangladesh
Original Articles · Vol. 3 No. 2 (2012)

Effect of Preoperative Chemotherapy in the Treatment of Advanced Wilms Tumor

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JPSB
Journal of
Paediatric Surgeons of Bangladesh
Published : July 2012
CONTENTSVolume 03Number 2July 2012
Editorial
Collaboration in Pediatric Surgical Training & Education among Asian Countries & Beyond – Bangladesh perspective
Abdul Hanif Tablu
54
Review Articles
Enuresis
Ashraf Ul Huq Kazal
78
Original Articles
Effect of Preoperative Chemotherapy in the Treatment of Advanced Wilms Tumor
Kaniz Hasina, Md Kamrul Hassan, Abdul Hanif, Abdur Rahed Khan, Muhammad Saiful Islam
56
Role of Ultrasound-Guided Hydrostatic Reduction of Intussusception in Children with Early Presentation
Md Shakhawat Hossain, Md Ashraf Ul Huq, Jafrul Hannan, Kaniz Hasina, RN Sarker
61
A Comparative Study to Evaluate the Outcome of Double Dartos Flap in Tubularized Incised Plate Urethroplasty for Distal Hypospadias Repair
Abhi Kumar Chakraborty, Sajal Kumar Majumdar, Mirza Kamrul Zahid, Sayed Mahmudur Rahman, Dipankar Kumar Saha, Khandoker Moynul Hasan
65
Incidence and Progress of Vesicoureteric Reflux after Primary Fulguration of Posteriorurethralvalves
MM Masud Pervez, Kaniz Hasina, Md Ashraf Ul Huq
71
Case Reports
Diaphragmatic Rupture in a Boy Following Blunt Abdominal Trauma- A Case Report
MA Mushfiqur Rahman, Md Minhajuddin Sajid, Md Abdullah Al Farooq, Md Akbar Husain Bhuiyan, Tanvir Kabir Chowdhury
81
Intestinal Atresia : A Case Report
Mohammad Shakhawat Hossain, Ashraf Ul Huq Kazal, Moinul Huque
85
Neuroblastoma neck in a 7-year-old girl: a very rare presentation
Rameez Shah, Sk Nurul Fatah Rumi
88
The Official Journal of the
ASSOCIATION OF PAEDIATRIC SURGEONS OF BANGLADESH (APSB)
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Authors

  • Kaniz HasinaAssociate professor, Dept. of Pediatric Surgery, Dhaka Medical College, Dhaka
  • Md Kamrul HassanAssistant professor. Dept. of Pediatric Surgery, Faridpur Medical College, Faridpur
  • Abdul HanifAssociate Professor, Dept. of Pediatric Surgery, Dhaka Medical College, Dhaka
  • Abdur Rahed KhanProfessor of Pediatric Surgery, Director, Dhaka Shishu (Children) Hospital, Dhaka
  • Muhammad Saiful IslamProfessor & Chairperson, Dept.of Pediatric Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka

Abstract

Introduction: The management of Wilms tumor still remains a matter of great challenge to pediatric surgeons and also to pediatric oncologists. The tumor continues to be the subject of intensive investigations that with the aid of co-operative protocols by the National Wilms Tumor Study (NWTS) have resulted in marked improvement in survival. Surgical excision remains the cornerstone of treatment of Wilms tumor; however the dramatic improvement in overall survival is the result of coordinated use of surgery, chemotherapy and radiation therapy. Materials and methods: This was a prospective study, started in September, 1999 and completed in November, 2000 in Pediatric Surgery department of Dhaka Shishu (Children) Hospital and Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Preoperative chemotherapy was given to all the patients of advanced Wilms tumor for four weeks with vincristine and actinomycin D according to the Societe Internationale d’Oncologie Pediatrique (SIOP) protocol (Herdrich K, 1982). The patients were followed up every 2 weekly by ultrasonography, LFT, Hb% and chest X-ray for one month. The size of the tumor as well as the metastatic lesions in the prechemotherapeutic and postchemotherapeutic ultrasonographic findings was compared after one month. Results: After giving neoadjuvant chemotherapy, the size of the tumor was reduced in 08 patients and it was measured by USG after one month. The change in the metastatic lesions was also compared by USG at the same time. Two patients died during the course of neoadjuvant chemotherapy and nephroureterectomy was done in 08 patients. All the resected specimens were sent for histopathology. The reports revealed features of Wilms tumor with favorable histology (FH) in 07 cases and unfavorable histology (UH) in 01 case. Conclusion: It is evident from this study that advanced stage of Wilms tumor, where operative treatment was not primarily possible, preoperative chemotherapy downsized the tumor significantly. It is then possible to perform nephroureterectomy.

Journal of Paediatric Surgeons of Bangladesh (2012) Vol. 3 (2): 56–60

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