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Apoptotic protein expression in favorable-histology Wilms tumor correlates with tumor recurrence

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Abstract

Purpose

Outcome for patients with Wilms tumor (WT) with favorable histology is good. Deletions of chromosomes 1p and 16q impart a poorer outcome. Value of apoptotic protein expression is not clear.

Methods

Expression of four immunohistochemically detectable apoptosis-regulating proteins (bcl-2, bcl-x, bax and p53) were analyzed in 30 specimens of WT and compared to recurrence and recurrence-free survival (RFS).

Results

The 30 patients included ranged from 4 to 72 months in age (mean 31). The mean available follow-up was 35.3 months (range 1–54). Six patients developed recurrence. The 5-year RFS for blastema-predominant tumors was 40% as compared to 91% for triphasic histology which was significant (p = 0.048). The 5-year RFS in patients with bcl-2 negative tumors was 63% as compared to 100% for bcl-2 positive tumors, the difference being significant (p = 0.019). The 5-year RFS in patients with p-53 positive tumors was 27% as compared to 91% for p-53 negative tumors; however, this difference in the RFS was not statistically significant (p = 0.143). bax and bcl-x expression were not related to the RFS.

Conclusions

Tumors that are bcl-2 negative have a relatively higher recurrence rate and a poorer RFS. They may benefit from a more intensive follow-up regime for early detection of recurrence.

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Authors and Affiliations

  1. Department of Pathology, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India

    Shipra Agarwal, Venkateswaran K. Iyer, Sandeep R. Mathur, Manju Aron, S. Datta Gupta & Kusum Verma

  2. Department of Paediatric Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India

    Sandeep Agarwala

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  1. Shipra Agarwal
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  2. Venkateswaran K. Iyer
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  3. Sandeep Agarwala
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  4. Sandeep R. Mathur
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  5. Manju Aron
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  6. S. Datta Gupta
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  7. Kusum Verma
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Correspondence to Venkateswaran K. Iyer.

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Agarwal, S., Iyer, V.K., Agarwala, S. et al. Apoptotic protein expression in favorable-histology Wilms tumor correlates with tumor recurrence. Pediatr Surg Int 27, 303–308 (2011). https://doi.org/10.1007/s00383-010-2740-0

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  • DOI: https://doi.org/10.1007/s00383-010-2740-0

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