Wilms' tumour and hypertension: incidence and outcome.
ABSTRACT To determine the incidence and outcome of hypertension associated with Wilms' tumour and to reduce peri-operative morbidity by appropriate treatment.
The medical and nursing case-notes of 17 consecutive patients with Wilms' tumour treated over a 5.5 year period (1989-1994) were analysed retrospectively.
Ten of 17 patients had hypertension, with a mean blood pressure of 150/103 mmHg (130-220 mmHg systolic and 85-145 mmHg diastolic). There was no significant difference between the hyper- and normotensive patients in their mode of presentation. Blood pressure was stabilized preoperatively in all the hypertensive patients. Perioperative monitoring in these patients was performed using arterial and central venous pressure lines. No patient had any peri-operative hyper- or hypotensive episodes caused by handling the tumour or after nephrectomy. Thirteen patients had a favourable histological diagnosis and all the hypertensive patients were in this group. The blood pressure of all patients returned to normal within 1 month of surgery.
Both the recognition of hypertension and appropriate peri-operative treatment is mandatory for the safe surgical management of this condition.
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Article: Secondary Forms of Hypertension
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ABSTRACT: There have been a number of advances that have increased our understanding of the biology of Wilms tumor during the last decade. This information is now being incorporated into current pediatric oncology protocols. We present a summary of these advances and outline the current treatment of Wilms tumor. The medical literature was reviewed with an emphasis on the molecular biology of Wilms tumor. The development of Wilms tumor involves several genes, including WT1, the Wilms tumor suppressor gene at 11p13. In addition, certain chromosomal regions (16q and 1p) might be used as prognostic factors for determining the intensity of therapy. Future protocols conducted by pediatric oncology groups will incorporate biological studies. The goal is to identify patients at low risk for relapse which will allow a reduction in treatment intensity and subsequent toxicity. Children at an increased risk for relapse can be selected for more intensive treatment.The Journal of Urology 04/1998; 159(4):1316-25. DOI:10.1097/00005392-199804000-00081 · 3.75 Impact Factor
- Medical and Pediatric Oncology 02/2002; 38(2):135-6. DOI:10.1002/mpo.1291.abs