Timing of adjuvant chemotherapy after laparotomy for Wilms tumor and neuroblastoma
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In brief
In brief
Retrospective study of 130 pediatric patients demonstrates that early adjuvant chemotherapy initiation (≤7 days post-surgery) for Wilms tumor and high-risk neuroblastoma is safe and feasible, with no increase in wound healing complications. Findings support accelerated treatment protocols in stable postoperative patients.
Written by the GCMD Library team from the article.
Abstract
Purpose
To describe the timing of chemotherapy initiation after surgery for Wilms tumor (WT) and neuroblastoma within a dedicated children’s cancer center.
Methods
A single-institution retrospective cohort study identified patients that underwent resection of unilateral WT or high-risk neuroblastoma and received adjuvant chemotherapy treatment. Adjuvant chemotherapy initiation and postoperative complications were recorded.
Results
Among 47 WT patients, the median time to chemotherapy initiation was 11 days [interquartile range IQR 7–14]. 3 WT patients had post-operative complications, but all preceded chemotherapy. Among 83 patients treated for high-risk neuroblastoma, the median time to chemotherapy was 11 days [IQR 9–14]. High-risk neuroblastoma patients with 30-day postoperative complications had a significantly longer time to initiation of adjuvant chemotherapy (odds ratio 1.13; p = 0.008). Many of these complications preceded and delayed the initiation of post-operative chemotherapy. No complications occurred in the group of 12 (25%) WT patients or 16 (19.3%) neuroblastoma patients who started chemotherapy ≤ 7 days after surgery.
Conclusion
There is no association between early initiation of adjuvant chemotherapy and post-operative complications including wound healing. Early initiation of chemotherapy (≤ 7 days) is feasible in unilateral WT or high-risk neuroblastoma patients who are otherwise doing well without resulting in a preponderance of wound healing complications.