Pediatric urologic oncology:
Gespeichert in:
| Beteiligte Personen: | , |
|---|---|
| Format: | Buch |
| Sprache: | Englisch |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2000
|
| Schriftenreihe: | The urologic clinics of North America
27,3 |
| Schlagwörter: | |
| Links: | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009085514&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| Umfang: | XI S., S. 383 - 583 zahlr. Ill., graph. Darst. |
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Datensatz im Suchindex
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| adam_text | PEDIATRIC UROLOGIC ONCOLOGY
CONTENTS
Preface xv
Jonathan H. Ross and Robert Kay
Neuroblastoma 383
Frederick Alexander
Neuroblastoma is a malignant tumor of neural crest origin that may arise
anywhere along the sympathetic ganglia or within the adrenal medulla.
The median age of diagnosis is 2 years; however occurrence is skewed
toward younger children, with nearly 35% of cases occurring under 1 year
of age and the remainder under 10 years of age. Seventy five percent of
neuroblastomas originate within the abdomen or pelvis, and half of these
occur within the adrenal medulla, whereas 20% originate within the poste¬
rior mediastinum and 5% within the neck.
Pheochromocytoma: Special Considerations in Children 393
Jonathan H. Ross
In children, pheochromocytomas are more often multifocal and extra
adrenal than in adults. This makes the diagnosis, localization, and surgical
management more challenging. Nonetheless, the standard biochemical
evaluation is usually diagnostic, and MR imaging is currently the best tool
for tumor localization. The possibility of a familial syndrome must always
be considered since there is a greater likelihood of a metachronous recur¬
rence in children. Consideration should be given to adrenal sparing sur¬
gery in selected patients. When managed appropriately, the outlook for
pheochromocytoma in children is excellent, although the uncommon ma¬
lignant tumors are still difficult to treat.
Adrenocortical Carcinoma in Children: Review and Recent
Innovations 403
Louis S. Liou and Robert Kay
Pediatric adrenocortical carcinoma is a rare, potentially fatal disease. The
majority of pediatric adrenocortical carcinomas are functional, but despite
the dramatic clinical presentation, most patients have a delay in diagnosis.
UROLOGIC CLINICS OF NORTH AMERICA
VOLUME 27 • NUMBER 3 • AUGUST 2000 vii
Although biochemical and histological diagnosis has remained largely
unchanged, radiographic evaluation has improved and new molecular
data have accrued. Unfortunately, despite these advances, treatment of the
disease has largely remained unchanged. New surgical techniques and
preoperative management have diminished the morbidity and mortality,
however. This review will give the reader increased familiarity with this
unusual tumor and hopefully, lead to earlier recognition, prompt interven¬
tion, and improved survival of these patients.
Principles of Wilms Tumor Biology 423
Max J. Coppes and Kathy Pritchard Jones
The last few years have provided dramatic breakthroughs in understand¬
ing the genetic factors involved in Wilms tumorigenesis and normal
kidney development. The implications of these findings for the clinical
management of children with Wilms tumor are only now becoming appar¬
ent. Over 80% of patients with Wilms tumor can be cured using contempo¬
rary multimodality therapy. As a consequence, the current NWTSG is
attempting to intensify treatment for patients with poor prognostic features
while decreasing therapy, and thereby adverse late effects, for patients
with favorable prognosticators.
Wilms Tumor: Overview of National Wilms Tumor Study
Group Results 435
Holly L. Neville and Michael L. Ritchey
Since its inception in 1969, the NWTSG has successfully performed studies
that are now the model for the management of pediatric malignancies.
Future studies may use genetic markers to stratify high risk patients be¬
yond the traditional staging system. Therapy will continue to be evaluated
to determine the minimal necessary therapy to achieve the best outcome
for children with Wilms tumor.
The Role of Preoperative Chemotherapy in the Management of
Wilms Tumor: The SIOP Studies 443
Norbert Graf, Marie France Tournade, and Jan de Kraker
Wilms tumor is the most common malignant renal tumor in children.
Dramatic improvements in survival have occurred as the result of ad¬
vances in anesthetic and surgical management, irradiation, and chemother¬
apy. Treatments are now based on several multicenter trials and studies
conducted by the International Society of Pediatric Oncology in Europe
and the National Wilms Tumor Study Group in the United States. The
main objectives of these trials and studies are to treat patients according
to well defined risk groups in an attempt to achieve the highest cure rates,
to decrease the frequency and intensity of acute and late toxicity, and to
minimize the cost of therapy.
Wilms Tumor: Surgical Considerations and Controversies 455
Walid Farhat, Gordon McLorie, and Gianpaolo Capolicchio
Although the therapeutic objectives for Wilms tumor are to maximize
outcomes and minimize treatment morbidity, there are some controversial
issues related to different therapeutic protocols. In this article, the authors
address some of the issues such as the roles of tumor biopsy, preoperative
chemotherapy, contralateral exploration, and partial nephrectomy.
viii CONTENTS
Non Wilms Renal Tumors in Children 463
Bruce Broecker
Renal tumors other than Wilms tumors are infrequent in childhood.
Wilms tumors account for 6% to 7% of childhood cancer, whereas the
remaining renal tumors account for less than 1%. The most common non
Wilms tumors are clear cell sarcoma of the kidney, rhabdoid tumor of the
kidney, renal cell carcinoma, mesoblastic nephroma, and multilocular cys¬
tic nephroma. Collectively, these tumors account for less than 10% of the
primary renal neoplasms in childhood.
Genitourinary Rhabdomyosarcoma: Treatment Options 471
Martin Kaefer and Richard C. Rink
Dramatic improvements have occurred in the treatment and prognosis of
the child with rhabdomyosarcoma over the past 2 decades. Increased
understanding of tumor behavior has improved survival and focused
attention on important quality of life issues. Future therapeutic advances
will depend largely on an improved molecular understanding of altered
cell behavior and the continued efforts of multi institutional studies.
Reconstructive Surgery for Children with Pelvic
Rhabdomyosarcoma 489
Terry W. Hensle and David T. Chang
Rhabdomyosarcoma is the most common soft tissue sarcoma found in
children and can arise almost anywhere skeletal muscle is found. It repre¬
sents 4% to 8% of malignant solid tumors in children, ranking behind
central nervous system tumors, lymphoma, neuroblastoma, and Wilms
tumor. Reconstructive surgery has become an integral part of the total
plan in patients undergoing radical surgery for rhabdomyosarcoma. Ad¬
vances in surgical techniques can often provide a reasonable lifestyle
for patients.
Current Management of Prepubertal Yolk Sac Tumors of the
Testis 503
Richard W. Grady
Over the last 3 decades, the management of pediatric yolk sac tumors of
the testis has changed significantly. These changes reflect improvement in
the treatment of testicular tumors in adults and children, such as the
advent of platinum based chemotherapy regimens. They also reflect in¬
creased understanding of the biology and natural history of prepubertal
yolk sac tumors of the testis as a unique disease entity.
Diagnosis and Management of Teratomas and Epidermoid Cysts 509
Christopher Walsh and H. Gil Rushton
Testicular tumors in children are rare and more often exhibit benign
behavior than tumors found in their adult counterparts. As a result, a less
aggressive approach to pediatric lesions has evolved in the past decade.
Testis sparing surgery is now considered the treatment of choice for many
prepubertal tumors. An updated review of the literature supports this
surgical approach for teratoma, epidermoid cysts, and benign cystic lesions
of the testis.
CONTENTS ix
Leydig Cell Tumors and Tumors Associated with Congenital
Adrenal Hyperplasia 519
Mark A. Rich and Michael A. Keating
Testicular cancers occur at a rate of 2 cases per 100,000 males. Gonadal
stromal tumors, including Leydig cell tumors and tumors of the adreno
genital syndrome, account for 1% to 3% of these neoplasms. Despite
their rarity, these hormone producing tumors are particularly interesting
because of their potential for causing endocrinologic manifestations in
prepubertal and adult males. They are also clinically significant, and early
identification is critical to avoid profound and often irreversible develop¬
mental changes in affected children. An accurate diagnosis is important to
differentiate tumors that will respond to medical management from tu¬
mors that require definitive surgical therapy.
The Spectrum of Sertoli Cell Tumors in Children 529
Joseph G. Borer, Puay E. Tan, and David A. Diamond
The spectrum of Sertoli cell tumors in children covers a wide range of
testis and ovarian tumors classified as sex cord stromal tumors. Sertoli cell
tumor of the testis is extremely rare in the pediatric population. The
American Academy of Pediatrics Section on Urology Prepubertal Testicular
Tumor Registry has reported a total of six cases of Sertoli cell tumor of
the testis, accounting for 1.3% of the 430 cases reported to the registry as
of October 1996. Despite their rarity, Sertoli cell variants of sex cord
stromal tumors have generated keen interest because of their variable
histologic appearance and biologic behavior, including endocrine activity.
Because sex cord stromal tumors occur in the ovary and testis, a primitive
cellular origin to these tumors is likely in males and females.
Tumors of the Testis in Intersex Syndromes . 543
Howard S. Levin
Patients with intersex syndrome are rare in the general population. In
these patients, cryptorchid gonads that have an Y chromosome or Y
chromosomal material are at risk for development of germinal and non
germinal neoplasm and non neoplastic masses. Diagnosis of individual
patients should be accurate for optimal care and risk assessment.
Radiotherapy for Pediatric Genitourinary Tumors: Its Role and
Long Term Consequences 553
Adir Ludin and Roger M. Macklis
Radiation therapy has traditionally played a major role in the treatment
of pediatric genitourinary malignancies. In particular, Wilms tumor, rhab
domyosarcoma, and neuroblastoma often include radiotherapy in the local
control phase of treatment. Recently, clinical trials have focused on decreas¬
ing the toxicity of radiotherapy through dose modifications and conformal
field arrangements. Radiotherapy will continue to be a major treatment
modality for this patient group if technologic advances in radiation deliv¬
ery continue to increase efficacy without comorbidities.
The Long Term Complications of Chemotherapy in Childhood
Genitourinary Tumors 563
Charles A. Sklar and Michael P. LaQuaglia
Combination chemotherapy, often in conjunction with surgery and exter¬
nal radiotherapy, is utilized in most children with tumors of the genitouri
x CONTENTS
nary tract. These chemotherapeutic agents are capable of causing a variety
of delayed toxicities. Common late complications include cardiotoxidty
associated with prior exposure to an anthracycline, pulmonary dysfunc¬
tion, infertility in males due to prior therapy with alkylating agents, and
secondary leukemia in individuals treated with epipodophyllotoxins.
The Craft of Urologic Surgery
Complete Primary Repair of Exstrophy: Surgical Technique 569
Richard W. Grady and Michael E. Mitchell
The single stage reconstructive approach to exstrophy evolved out of
changes in the management of exstrophy. The success of Jeffs and others
that functionally reconstructed the bladder of patients with exstrophy
demonstrated that the approach was feasible and acceptable. Increased
understanding of the anatomic pathology associated with exstrophy and
epispadias resulted in the development of complete penile disassembly
for epispadias and the extension of this technique to exstrophy as the
complete primary repair technique described herein. The results using
this technique are encouraging, leading to the recommendation for the
procedure by other surgeons committed to the care of patients with ex¬
strophy.
Index 579
Subscription Information Inside back cover
CONTENTS Xi
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| series | The urologic clinics of North America |
| series2 | The urologic clinics of North America |
| spellingShingle | Grady, Richard W. Mitchell, Michael E. 1943- Pediatric urologic oncology The urologic clinics of North America Urogenitalkrebs (DE-588)4133891-1 gnd Urologische Onkologie (DE-588)4199201-5 gnd Kind (DE-588)4030550-8 gnd |
| subject_GND | (DE-588)4133891-1 (DE-588)4199201-5 (DE-588)4030550-8 (DE-588)4143413-4 |
| title | Pediatric urologic oncology |
| title_alt | Surgical craft: complete primary repair of exstrophy Complete primary repair of exstrophy |
| title_auth | Pediatric urologic oncology |
| title_exact_search | Pediatric urologic oncology |
| title_full | Pediatric urologic oncology Jonathan H. Ross ... guest ed. |
| title_fullStr | Pediatric urologic oncology Jonathan H. Ross ... guest ed. |
| title_full_unstemmed | Pediatric urologic oncology Jonathan H. Ross ... guest ed. |
| title_short | Pediatric urologic oncology |
| title_sort | pediatric urologic oncology |
| topic | Urogenitalkrebs (DE-588)4133891-1 gnd Urologische Onkologie (DE-588)4199201-5 gnd Kind (DE-588)4030550-8 gnd |
| topic_facet | Urogenitalkrebs Urologische Onkologie Kind Aufsatzsammlung |
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