Diagnosis and Surgical Care of Pediatric Cancers

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Surgery".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 3346

Special Issue Editors


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Guest Editor
Department of Pediatric Surgery and Urology, Institute of Maternal and Child Health - IRCCS "Burlo Garofolo", 34137 Trieste, Italy
Interests: pediatric surgery; gastrointestinal surgery; minimally invasive surgery; congenital abnormalities; laparoscopic surgery; abdominal surgery

E-Mail Website
Guest Editor
Department of Pediatric Surgery and Urology, Institute of Maternal and Child Health - IRCCS "Burlo Garofolo", 34137 Trieste, Italy
Interests: endoscopic surgery; prenatal diagnostics and counselling; pulmonary malformation; short bowel; bacterial translocation
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Special Issue Information

Dear Colleagues,

Cancer is attested to be the second most prevalent cause of mortality among children aged 1 to 14 years, to date. Significant progresses have been observed in the field of diagnosis and treatment of pediatric cancers in recent decades. However, surgery remains a cornerstone of the management of pediatric cancers, whether performed at presentation or following neoadjuvant therapies. Notably, in recent years, new techniques have been incorporated into the armamentarium of surgeons dealing with pediatric cancer patients. In particular, laparoscopic- and robotic-assisted surgery have carved their space in the adult cancer population with evidence supporting less pain, shorter hospital stays, lower complications, and equivalent long-term survival and oncologic outcomes; and hopefully they may have a role in pediatric cancer surgery as well. In addition, the improvement in the quality imaging has allowed a three-dimensional visualization and printing to be incorporated into surgical practice, and fluorescence-guided surgery showed the advantage to distinguish anatomical or physiologic differences between cancer and normal tissue.

This Special Issue aims to discuss advances in diagnosis and surgical care of cancers in pediatric age. Colleagues and researchers are invited to submit their manuscripts.

We look forward to receiving your valuable contributions.

Dr. Alessandro Boscarelli
Dr. Jurgen Schleef
Guest Editors

Manuscript Submission Information

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Keywords

  • pediatric cancers
  • minimally invasive
  • cancer diagnosis
  • recent advances
  • pediatric surgery
  • children

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Published Papers (3 papers)

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14 pages, 2167 KiB  
Article
Exploring Pediatric Vertebral, Sacral, and Pelvic Osteosarcomas through the NCDB: Demographics, Treatment Utilization, and Survival Outcomes
by Pemla Jagtiani, Mert Karabacak, Matthew T. Carr, Zeynep Bahadir, Peter F. Morgenstern and Konstantinos Margetis
Children 2024, 11(8), 1025; https://doi.org/10.3390/children11081025 - 21 Aug 2024
Viewed by 534
Abstract
Background and Objectives: Retrieve data from the National Cancer Database (NCDB) to examine information on the epidemiological prevalence, treatment strategies, and survival outcomes of pediatric vertebral, sacral and pelvic osteosarcomas. Methods: We reviewed NCDB data from 2008 to 2018, concentrating on vertebral, sacral, [...] Read more.
Background and Objectives: Retrieve data from the National Cancer Database (NCDB) to examine information on the epidemiological prevalence, treatment strategies, and survival outcomes of pediatric vertebral, sacral and pelvic osteosarcomas. Methods: We reviewed NCDB data from 2008 to 2018, concentrating on vertebral, sacral, and pelvic osteosarcomas in children 0 to 21 years. Our analysis involved logistic and Poisson regression, Kaplan-Meier survival estimates, and Cox proportional hazards models. Results: The study population included 207 patients. For vertebral osteosarcomas, 62.5% of patients were female, and 78.1% were white. Regional lymph node involvement predicted 80 times higher mortality hazard (p = 0.021). Distant metastasis predicted 25 times higher mortality hazard (p = 0.027). For sacral and pelvic osteosarcomas, 58.3% of patients were male, and 72% were white. Patients with residual tumor were 4 times more likely to have prolonged LOS (p = 0.031). No residual tumor (HR = 0.53, p = 0.03) and radiotherapy receipt (HR = 0.46, p = 0.034) were associated with lower mortality hazards. Distant metastasis predicted 3 times higher mortality hazard (p < 0.001). Hispanic ethnicity was linked to lower resection odds (OR = 0.342, p = 0.043), possibly due to language barriers affecting patient understanding and care decisions. Conclusions: In conclusion, our examination of NCDB offers a thorough exploration of demographics, treatment patterns, and results, highlighting the importance of personalized approaches to enhance patient outcomes. Full article
(This article belongs to the Special Issue Diagnosis and Surgical Care of Pediatric Cancers)
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12 pages, 2877 KiB  
Article
Surgery in Bilateral Wilms Tumor—A Single-Center Experience
by Fernanda Kelly Marques de Souza, Mayara Caroline Amorim Fanelli, Alexandre Alberto Barros Duarte, Maria Teresa de Seixas Alves, Henrique Manoel Lederman, Monica dos Santos Cypriano and Simone de Campos Vieira Abib
Children 2023, 10(11), 1790; https://doi.org/10.3390/children10111790 - 7 Nov 2023
Cited by 1 | Viewed by 1373
Abstract
The treatment of bilateral Wilms tumors (BWT) involves curing the cancer, preserving long-term renal function, and maintaining a good quality of life. Established methods for achieving these goals include preoperative chemotherapy and nephron-sparing surgery (NSS). This study aimed to evaluate the experience of [...] Read more.
The treatment of bilateral Wilms tumors (BWT) involves curing the cancer, preserving long-term renal function, and maintaining a good quality of life. Established methods for achieving these goals include preoperative chemotherapy and nephron-sparing surgery (NSS). This study aimed to evaluate the experience of a single institution in treating patients with BWT. We analyzed cases of BWT treated at the Pediatric Oncology Institute—GRAACC—Federal University of São Paulo over a period of 35 years. Bleeding control was performed with manual compression of the renal parenchyma. Thirty-three patients were included in the study. Thirty cases were synchronous tumors. The mean age at diagnosis was 30.4 months (±22 m) and 66.7% were girls. The median follow-up period was 83 months. Neoadjuvant chemotherapy was the primary approach in most patients (87.9%), with a simultaneous upfront surgical approach performed in 84.8%. Most patients underwent bilateral NSS (70.4%). There were no early complications in this series, but 39.4% had clinical complications. The five-year survival rate was 76%. Therefore, it is clear that the surgical approach to BWT plays a crucial role in achieving good outcomes. However, it is difficult to standardize surgical techniques and technology may have the potential to enhance safety. Full article
(This article belongs to the Special Issue Diagnosis and Surgical Care of Pediatric Cancers)
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23 pages, 6951 KiB  
Review
Wilms Tumor with Vena Caval Intravascular Extension: A Surgical Perspective
by Daniel B. Gehle, Zachary D. Morrison, Huma F. Halepota, Akshita Kumar, Clark Gwaltney, Matthew J. Krasin, Dylan E. Graetz, Teresa Santiago, Umar S. Boston, Andrew M. Davidoff and Andrew J. Murphy
Children 2024, 11(8), 896; https://doi.org/10.3390/children11080896 - 25 Jul 2024
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Abstract
Wilms tumor (WT) is the most common kidney tumor in pediatric patients. Intravascular extension of WT above the level of the renal veins is a rare manifestation that complicates surgical management. Patients with intravascular extension are frequently asymptomatic at diagnosis, and tumor thrombus [...] Read more.
Wilms tumor (WT) is the most common kidney tumor in pediatric patients. Intravascular extension of WT above the level of the renal veins is a rare manifestation that complicates surgical management. Patients with intravascular extension are frequently asymptomatic at diagnosis, and tumor thrombus extension is usually diagnosed by imaging. Neoadjuvant chemotherapy is indicated for thrombus extension above the level of the hepatic veins and often leads to thrombus regression, obviating the need for cardiopulmonary bypass in cases of cardiac thrombus at diagnosis. In cases of tumor extension to the retrohepatic cava, neoadjuvant therapy is not strictly indicated, but it may facilitate the regression of tumor thrombi, making resection safer. Hepatic vascular isolation and cardiopulmonary bypass increase the risk of bleeding and other complications when utilized for tumor thrombectomy. Fortunately, WT patients with vena caval with or with intracardiac extension have similar overall and event-free survival when compared to patients with WT without intravascular extension when thrombectomy is successfully performed. Still, patients with metastatic disease at presentation or unfavorable histology suffer relatively poor outcomes. Dedicated pediatric surgical oncology and pediatric cardiothoracic surgery teams, in conjunction with multimodal therapy directed by a multidisciplinary team, are preferred for optimized outcomes in this patient population. Full article
(This article belongs to the Special Issue Diagnosis and Surgical Care of Pediatric Cancers)
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