Pediatric Nephrology

, Volume 27, Issue 6, pp 911–916 | Cite as

Renal tumours: long-term outcome

Educational Review

Abstract

Childhood cancer is rare, with an incidence of 100 new cases per million children and with renal tumours contributing 7% of cases. The introduction of multimodality treatment, surgery, radiotherapy and chemotherapy, has led to an exponential increase in the 5-year survival rate to >80%. However, this successful treatment has led to the development of late adverse effects. These treatment-related effects can cause premature deaths and increased morbidity compared with patients’ peers. Radiation causes damage to tissue and organs within the radiation field, affecting growth and function, and is largely responsible for the leading cause of death, namely, second malignant neoplasms. Another important late effect is cardiac dysfunction due to anthracycline use with or without cardiac radiation. In addition, a few patients have genetic abnormalities predisposing to Wilms tumour development, which result in renal dysfunction in the long term and may be exacerbated by cancer treatment regimens. Awareness of late consequences of cancer treatment is important, as early recognition can improve outcome. When presented with a patient with a history of renal tumours, it is vital to enquire about previous treatment to understand whether it is relevant to the presenting problem.

Keywords

Childhood Renal cancer Late effects Survivorship 

Notes

References

  1. 1.
    Kroll ME, Passmore SJ, Stiller CA (2004) Childhood cancer - UK. In: Toms JR (ed) CancerStats Monograph 2004. Cancer Research UK, London, pp 63–72Google Scholar
  2. 2.
    Pritchard-Jones K, Pritchard J (2004) Success of clinical trials in childhood Wilms tumour around the world. Lancet 364:1468–1470PubMedCrossRefGoogle Scholar
  3. 3.
    Cotton CA, Peterson S, Norkool PA, Takashima J, Grigoriev Y, Green DM, Breslow NE (2009) Early and late mortality after diagnosis of Wilms tumor. J Clin Oncol 27:1304–1309PubMedCrossRefGoogle Scholar
  4. 4.
    Armstrong GT, Liu Q, Yasui Y, Neglia JP, Leisenring W, Robison LL, Mertens AC (2009) Late mortality among 5-year survivors of childhood cancer: a summary from the childhood cancer survivor study. J Clin Oncol 27:2328–2338PubMedCrossRefGoogle Scholar
  5. 5.
    Reulen RC, Winter DL, Frobisher C, Lancashire ER, Stiller CA, Jenney ME, Skinner R, Stevens MC, Hawkins MM (2010) British childhood cancer survivor study steering group long-term cause-specific mortality among survivors of childhood cancer. JAMA 304:172–179PubMedCrossRefGoogle Scholar
  6. 6.
    Termuhlen AM, Tersak JM, Liu Q, Yasui Y, Stovall M, Weathers R, Deutsch M, Sklar CA, Oeffinger KC, Armstrong G, Robison LL, Green DM (2011) Twenty-five year follow-up of childhood Wilms tumor: a report from the childhood cancer survivor study Pediatr Blood CancerGoogle Scholar
  7. 7.
    Geenen MM, Cardous-Ubbink MC, Kremer LC, van den Bos C, van der Pal HJ, Heinen RC, Jaspers MW, Koning CC, Oldenburger F, Langeveld NE, Hart AA, Bakker PJ, Caron HN, van Leeuwen FE (2007) Medical assessment of adverse health outcomes in long-term survivors of childhood cancer. JAMA 297:2705–2715PubMedCrossRefGoogle Scholar
  8. 8.
    Goorin AM, Chauvenet AR, Perez-Atayde AR (1996) Initial congestive heart failure six to ten years after doxorubicin chemotherapy for childhood cancer. J Pediat 116:144–147CrossRefGoogle Scholar
  9. 9.
    Steinherz LJ, Steinherz G, Tan CJ (1991) Cardiac toxicity 4 to 20 years after completing anthracycline therapy. JAMA 266:1672–1677PubMedCrossRefGoogle Scholar
  10. 10.
    Sorensen K, Levitt G, Sebag-Montefiore D, Bull C, Sullivan I (1995) Cardiac function in Wilms tumor survivors. J Clin Oncol 13:1546–1556PubMedGoogle Scholar
  11. 11.
    Green DM, Grigoriev YA, Nan B, Takashima JR, Norkool PA, D’Angio GJ, Breslow NE (2001) Congestive heart failure after treatment for Wilms tumor: a report from the National Wilms Tumor Study Group. J Clin Oncol 19:1926–1934PubMedGoogle Scholar
  12. 12.
    Green DM, Grigoriev YA, Nan B, Takashima JR, Norkool PA, D'Angio GJ, Breslow NE (2003) Correction to “Congestive heart failure after treatment for Wilms tumor”. J Clin Oncol 21:2447–2448PubMedCrossRefGoogle Scholar
  13. 13.
    Pein F, Sakiroglu O, Dahan M, Lebidois J, Merlet P, Shamsaldin A, Villain E, de Vathaire F, Sidi D, Hartmann O (2004) Cardiac abnormalities 15 years and more after Adriamycin therapy in 229 childhood survivors of a solid tumour at the Institut Gustave Roussy. Br J Cancer 91:37–44PubMedCrossRefGoogle Scholar
  14. 14.
    Sorensen K, Levitt GA, Bull C, Dorup I, Sullivan ID (2003) Late anthracycline cardiotoxicity after childhood cancer: a prospective longitudinal study. Cancer 97:1991–1998PubMedCrossRefGoogle Scholar
  15. 15.
    Levitt G, Anazodo A, Burch M, Bunch K (2009) Cardiac or cardiopulmonary transplantation in childhood cancer survivors: An increasing need? Eur J Cancer 45:3027–3034PubMedCrossRefGoogle Scholar
  16. 16.
    Bailey S, Roberts A, Brock C, Price L, Craft AW, Kilkarni R, Lee RE, Skillen AW, Skinner R (2002) Nephrotoxicity in survivors of Wilms tumours in the North of England. Br J Cancer 87:1092–1098PubMedCrossRefGoogle Scholar
  17. 17.
    Skinner R, Levitt G, Wallace WH. Therapy based LTFU practice statement UKCCSG (2005) www.ukccsg.org.uk/public/followup/PracticeStatement/index.html
  18. 18.
    Breslow NE, Collins AJ, Ritchey ML, Grigoriev YA, Peterson SM, Green DM (2005) End stage renal disease in patients with Wilms tumor: results from the National Wilms Tumor Study Group and the United States Renal Data System. J Urol 174:1972–1975PubMedCrossRefGoogle Scholar
  19. 19.
    Breslow NE, Takashima JR, Ritchey ML, Strong LC, Green DM (2000) Renal failure in the Denys-Drash and Wilms tumor-aniridia syndromes. Cancer Res 60:4030–4032PubMedGoogle Scholar
  20. 20.
    Levitt GA, Yeomans E, Dicks Mireaux C, Breatnach F, Kingston J, Pritchard J (1992) Renal size and function after cure of Wilms tumour. Br J Cancer 66:877–882PubMedCrossRefGoogle Scholar
  21. 21.
    Gutierrez-Millet V, Nieto J, Praga M, Usera G, Martinez MA, Morales JM (1986) Focal glomerulosclerosis and proteinuria in patients with solitary kidneys. Arch Intern Med 146:705–709PubMedCrossRefGoogle Scholar
  22. 22.
    Welch TR, McAdams AJ (1986) Focal glomerulosclerosis as a late sequela of Wilms tumor. J Pediatr 108:105–109PubMedCrossRefGoogle Scholar
  23. 23.
    Mitus A, Tefft M, Fellers FX (1969) Long term follow up of renal function of 108 children who underwent nephrectomy for malignant disease. Pediatrics 44:912–921PubMedGoogle Scholar
  24. 24.
    Finklestein JZ, Norkool P, Green DM, Breslow N, D'Angio GJ (1993) Diastolic hypertension in Wilms tumor survivors: a late effect of treatment? A report from the National Wilms Tumor Study Group. Am J Clin Oncol 16:201–205PubMedCrossRefGoogle Scholar
  25. 25.
    Srinivas M, Agarwala S, Padhy AK, Gupta AK, Bajpai M, Bhatnagar V, Gupta DK, Mitra DK (1998) Somatic growth and renal function after unilateral nephrectomy for Wilms tumor. Pediatr Surg Int 14:185–188PubMedCrossRefGoogle Scholar
  26. 26.
    Loebstein R, Koren G (1998) Ifosfamide-induced nephrotoxicity in children: critical review of predictive risk factors. Pediatrics 101:E8PubMedCrossRefGoogle Scholar
  27. 27.
    Skinner R, Cotterill SJ, Stevens MC (2000) Risk factors for nephrotoxicity after ifosfamide treatment in children: a UKCCSG Late Effects Group study. United Kingdom Children’s Cancer Study Group. Br J Cancer 82:1636–1645PubMedCrossRefGoogle Scholar
  28. 28.
    Rossi R, Godde A, Kleinebrand M, Riepenhausen M, Boos J, Ritter J, Jürgens H (1994) Unilateral nephrectomy and cisplatin as risk factors of ifosfamide induced nephrotoxicity: analysis of 120 patients. J Clin Oncol 12:159–165PubMedGoogle Scholar
  29. 29.
    Fels LM, Bokemeyer C, van Rhee J, Schmoll HJ, Stolte H (1996) Evaluation of late nephrotoxicity in long-term survivors of Hodgkin’s disease. Oncology 53:73–78PubMedCrossRefGoogle Scholar
  30. 30.
    Stohr W, Paulides M, Bielack S, Jurgens H, Treuner J, Rossi R, Langer T, Beck JD (2007) Ifosfamide-induced nephrotoxicity in 593 sarcoma patients: a report from the Late Effects Surveillance System. Pediatr Blood Cancer 48:447–452PubMedCrossRefGoogle Scholar
  31. 31.
    Aleksa K, Woodland C, Koren G (2001) Young age and the risk for ifosfamide-induced nephrotoxicity: a critical review of two opposing studies. Pediatr Nephrol 16:1153–1158PubMedCrossRefGoogle Scholar
  32. 32.
    Loebstein R, Atanackovic G, Bishai R, Wolpin J, Khattak S, Hashemi G, Gobrial M, Baruchel S, Ito S, Koren G (1999) Risk factors for long-term outcome of ifosfamide-induced nephrotoxicity in children. J Clin Pharmacol 39:454–461PubMedGoogle Scholar
  33. 33.
    Skinner R, Parry A, Price L, Cole M, Craft AW, Pearson AD (2010) Glomerular toxicity persists 10 years after ifosfamide treatment in childhood and is not predictable by age or dose. Pediatr Blood Cancer 54:983–989PubMedCrossRefGoogle Scholar
  34. 34.
    Daw NC, Gregornik D, Rodman J, Marina N, Wu J, Kun LE, Jenkins JJ, McPherson V, Wilimas J, Jones DP (2009) Renal function after ifosfamide, carboplatin and etoposide (ICE) chemotherapy, nephrectomy and radiotherapy in children with Wilms tumour. Eur J Cancer 45:99–106PubMedCrossRefGoogle Scholar
  35. 35.
    Kenney LB, Kenney LB, Laufer MR, Grant FD, Grier H, Diller L (2001) High risk of infertility and long term gonadal damage in males treated with high dose cyclophosphamide for sarcoma during childhood. Cancer 91:613–621PubMedCrossRefGoogle Scholar
  36. 36.
    Williams D, Crofton PM, Levitt G (2008) Does ifosfamide affect gonadal function? Pediatr Blood Cancer 50:347–351PubMedCrossRefGoogle Scholar
  37. 37.
    Green DM, Lange JM, Peabody EM, Grigorieva NN, Peterson SM, Kalapurakal JA, Breslow NE (2010) Pregnancy outcome after treatment for Wilms tumor: a report from the national Wilms tumor long-term follow-up study. J Clin Oncol 28:2824–2830PubMedCrossRefGoogle Scholar
  38. 38.
    Li FP, Gimbrere K, Gelber RD, Flamant F, Green DM, Heyn RM, Meadows AT (1987) Outcome of pregnancy in survivors of Wilms tumor. JAMA 257:216–219PubMedCrossRefGoogle Scholar
  39. 39.
    Byrne J, Mulvihill JJ, Connelly RR, Austin DA, Holmes GE, Holmes FF, Latourette HB, Meigs JW, Strong LC, Myers MH (1988) Reproductive problems and birth defects in survivors of Wilms tumor and their relatives. Med Pediatr Oncol 16:233–240PubMedCrossRefGoogle Scholar
  40. 40.
    Nicholson HS, Blask AN, Markle BM, Reaman GH, Byrne J (1996) Uterine anomalies in Wilms tumor survivors. Cancer 78:887–891PubMedCrossRefGoogle Scholar
  41. 41.
    Libshitz HI, Cohen MA (1982) Radiation induced osteochondromas. Radiology 142:643–647PubMedGoogle Scholar
  42. 42.
    Jaffe N, Ried HL, Cohen M, McNeese MD, Sullivan MP (1983) Radiation induced osteochondroma in long-term survivors of childhood cancer. Int J Radiat Oncol Biol Phys 9:665–670PubMedCrossRefGoogle Scholar
  43. 43.
    Tsuchiya H, Morikawa S, Tomita K (1990) Osteosarcoma arising from a multiple exostosis lesion: case report. Jpn J Clin Oncol 20:296–298PubMedGoogle Scholar
  44. 44.
    Walker DA, Dillon M, Levitt G, Cervera A, Shaw D, Pritchard J (1992) Mulitple exotosis (osteochondroma) and Wilms tumour - a possible association. Med Pediatr Oncol 20:360–361PubMedCrossRefGoogle Scholar
  45. 45.
    Jennes I, Pedrini E, Zuntini M, Mordenti M, Balkassmi S, Asteggiano CG, Casey B, Bakker B, Sangiorgi L, Wuyts W (2009) Multiple osteochondromas: mutation update and description of the multiple osteochondromas mutation database (MOdb). Hum Mutat 30:1620–1627PubMedCrossRefGoogle Scholar
  46. 46.
    Breslow NE, Takashima JR, Whitton JA, Moksness J, D'Angio GJ, Green DM (1995) Second malignant neoplasms following treatment for Wilms tumor: a report from the National Wilms Tumor Study Group. J Clin Oncol 13:1851–1859PubMedGoogle Scholar
  47. 47.
    Taylor AJ, Winter DL, Pritchard-Jones K, Stiller CA, Frobisher C, Lancashire ER, Reulen RC, Hawkins MM (2008) Second primary neoplasms in survivors of Wilms tumour-a population-based cohort study from the British Childhood Cancer Survivor Study. Int J Cancer 122:2085–2093PubMedCrossRefGoogle Scholar
  48. 48.
    Breslow NE, Lange JM, Friedman DL, Green DM, Hawkins MM, Murphy MFG, Neglia JP, Olsen JH, Peterson SM, Stiller CA, Robison LL (2010) Secondary malignant neoplasms following Wilms Tumor: an International Collaborative Study. Int J Cancer Int J Cancer 127:657–666Google Scholar
  49. 49.
    Shalet SM, Gibson B, Swindell R, Pearson D (1987) Effect of spinal irradiation on growth. Arch Dis Child 62:461–464PubMedCrossRefGoogle Scholar
  50. 50.
    Makiprnaa A, Keikkila JT, Merikanto J, Marttinen E, Siimes MA (1993) Spinal deformity induced by radiotherapy for solid tumours in childhood: a long term study. Eur J Pediat 152:197–200CrossRefGoogle Scholar
  51. 51.
    Reulen RC, Winter DL, Lancashire ER, Zeegers MP, Jenney ME, Walters SJ, Jenkinson C, Hawkins MM (2007) Health-status of adult survivors of childhood cancer: a large-scale population-based study from the British Childhood Cancer Survivor Study. Int J Cancer 121:633–640PubMedCrossRefGoogle Scholar
  52. 52.
    Pang JW, Friedman DL, Whitton JA, Stovall M, Mertens AC, Robison LL, Weiss NS (2008) Employment status among adult survivors in the Childhood Cancer Survivor Study. Pediatr Blood Cancer 50:104–110PubMedCrossRefGoogle Scholar
  53. 53.
    Gurney JG, Krull KR, Kadan-Lottick N, Nicholson HS, Nathan PC, Zebrack B, Tersak JM, Ness KK (2009) Social outcomes in the Childhood Cancer Survivor Study cohort. J Clin Oncol 27:2390–2395PubMedCrossRefGoogle Scholar
  54. 54.
    Lahteenmaki PM, Sankila R, Pukkala E, Kyyronen P, Harila-Saari A (2008) Scholastic achievement of children with lymphoma or Wilms tumor at the end of comprehensive education - a nationwide, register-based study. Int J Cancer 123:2401–2405PubMedCrossRefGoogle Scholar
  55. 55.
    National Cancer Survivorship initiative http://www.ncsi.org.uk/

Copyright information

© IPNA 2011

Authors and Affiliations

  1. 1.Department of Oncology/HaematologyGreat Ormond Street Hospital for Children NHS TrustLondonUK

Personalised recommendations