術後 2 年以上を経過して再発した Wilms 腫瘍症例の検討

概要

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We report herein a patient (2-year-old girl) with Wilms' tumor (Stage III) in whom a relapse occurred 30 months after surgery and discuss together with 4 of 7 cases with Wilms' tumor reported by the Research Committee of Malignant Surgical Pediatric Tumors in the Kyushu Area, as deaths following a relapse. These patients had survived for over 3 years after the primary surgery. Of these four, two were evidently having relapse despite the absence of tumor for 17 months, and 18 months that was beyond the Collins' dangerous range. In 7 cases reported by the Committee, four had been diagnosed as Stage I or II at the primary surgery but all these patients died of pulmonary or hepatic metastases. These results imply the importance of adequate postoperative antineoplastic chemotherapy. Despite the evidence that manifestation of tumor recurrence is often retarded by postoperative chemotherapy and radiotherapy, nevertheless, there are recurrences even 2 years after the surgery or beyond the Collins' dangerous range. Thus, all such patients should be followed carefully at least 4-5 years postoperatively, as there are often recurrences.
日本小児外科学会の論文