1. Characteristics and Outcome of Children with Wilms Tumor Requiring Intensive Care Admission in First Line Therapy
- Author
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Anouk Steur, Paulien A. M. A. Raymakers-Janssen, Martin C. J. Kneyber, Sandra Dijkstra, Job B. M. van Woensel, Dick A. van Waardenburg, Cornelis P. van de Ven, Alida F. W. van der Steeg, Marc Wijnen, Marc R. Lilien, Ronald R. de Krijger, Harm van Tinteren, Annemieke S. Littooij, Geert O. Janssens, Annemarie M. L. Peek, Godelieve A. M. Tytgat, Annelies M. Mavinkurve-Groothuis, Martine van Grotel, Marry M. van den Heuvel-Eibrink, Roelie M. Wösten-van Asperen, Paediatric Intensive Care, ARD - Amsterdam Reproduction and Development, Paediatric Oncology, CCA - Cancer Treatment and Quality of Life, Kindergeneeskunde, MUMC+: MA Medische Staf Kindergeneeskunde (9), RS: NUTRIM - R1 - Obesity, diabetes and cardiovascular health, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Groningen Energy & Sustainability Programme, and Pediatrics
- Subjects
PROTOCOL ,SURVIVORS ,Cancer Research ,SIOP WT 2001 ,HYPERTENSION ,NEPHRECTOMY ,INTERMEDIATE-RISK ,Wilms tumor ,intensive care ,pediatric oncology ,risk factors ,outcome ,Pediatric oncology ,CANCER ,CLASSIFICATION ,RENAL TUMORS ,Oncology ,Risk factors ,INTRACARDIAC EXTENSION ,Intensive care ,Outcome - Abstract
Survival rates are excellent for children with Wilms tumor (WT), yet tumor and treatment-related complications may require pediatric intensive care unit (PICU) admission. We assessed the frequency, clinical characteristics, and outcome of children with WT requiring PICU admissions in a multicenter, retrospective study in the Netherlands. Admission reasons of unplanned PICU admissions were described in relation to treatment phase. Unplanned PICU admissions were compared to a control group of no or planned PICU admissions, with regard to patient characteristics and short and long term outcomes. In a multicenter cohort of 175 children with an underlying WT, 50 unplanned PICU admissions were registered in 33 patients. Reasons for admission were diverse and varied per treatment phase. Younger age at diagnosis, intensive chemotherapy regimens, and bilateral tumor surgery were observed in children with unplanned PICU admission versus the other WT patients. Three children required renal replacement therapy, two of which continued dialysis after PICU discharge (both with bilateral disease). Two children died during their PICU stay. During follow-up, hypertension and chronic kidney disease (18.2 vs. 4.2% and 15.2 vs. 0.7%) were more frequently observed in unplanned PICU admitted patients compared to the other patients. No significant differences in cardiac morbidity, relapse, or progression were observed. Almost 20% of children with WT required unplanned PICU admission, with young age and treatment intensity as potential risk factors. Hypertension and renal impairment were frequently observed in these patients, warranting special attention at presentation and during treatment and follow-up.
- Published
- 2022
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