The relationship between lymph node involvement,sampling quantity and prognosis in pediatric patients with nephroblastoma
Objective To analyze the relationship between lymph node involvement,the number of samples and prognosis in children with Wilms tumor(WT).Methods The clinical data of 157 children with WT admitted from September 2010 to May 2018 were collected.The effects of lymph node involvement and the number of samples on 5-year event-free survival(EFS)were analyzed.Results The 5-year EFS in WT children with lymph node involvement was 50.00%(10/20).The 5-year EFS in WT children without lymph node involvement was 87.59%(120/137).The 5-year EFS in children without lymph nodes involvement was significantly longer than that children with lymph node involvement(P＜0.05).In the subgroups of different pathological types,the in-fluence of lymph node involvement on the prognosis of children with unfavorable histology(uFH)was significantly greater than that of children with favorable histology(FH)(P＜0.05).The median number of lymph nodes sampled was 3(0～18)in children without lymph node involvement and 9(2-23)in children with lymph node involvement.When more than 7 lymph nodes were sampled during the operation,the probability of positive lymph nodes was higher.When the number of intraoperative sampling was 10 or more,the positive rate of lymph nodes was not significantly increased.In different pathological type,there was no statistically significant difference in the number of lymph node samples taken during surgery whether WT children undergoing chemotherapy before surgery(P＞0.05).There were significant differences in the number of intraoperative sampling in WT children with different clinical stages(P＜0.05).The lymph node numbers were 7 and above in 13.46%stage Ⅰ children and 27.14%of stage Ⅱ children during intraoperative collection,while at least 7 lymph nodes in 40.00%of stageⅢperiod during intraoperative collection.There was no sig-nificant difference in 5-year EFS rate between stageⅡandⅢWT children with different sample numbers(P＞0.05).Conclusions Lymph node involvement is an important factor leading to poor prognosis in children with WT.The number of lymph nodes sampled has no independent predictive value for the prognosis of children with WT.When the number of lymph nodes sampled is more than 7,the probability of positive lymph nodes is greatly increased.
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