Étude anatomoclinique et pronostique des néphroblastomes dans le centre tunisien

Abstract

Nephroblastoma is a commun malignant tumour in childhood that benefited from therapeutic progress. This is a retrospective study of 35 nephroblastoma diagnosed and treated in the central region of Tunisia within the last 8 years (1991–1999). We report and compare clinical features, therapeutic results and prognostic factors with those reported in the literature. The mean age was 3-years and 9 months, and the main clinical symptom was abdominal mass. Pre-operative chemotherapy was done in 32 cases and the objective response rate was 58%. Thirty-three patients had radical nephrectomy and only one had partial nephrectomy. Histologic analysis concluded to an anaplastic nephroblastoma in 2 cases. Using the classification of the international society of pediatric oncology, 11.4% of tumours were stage I, 48.6% stage II, 5.7% stage III, 11.4% stage IV and 2.9% stage V. The overall 5 years survival was 80%; tumour relapse was only independant prognosis factor in multivariate analysis ( P < 0,01). Prognosis of nephroblastoma has been improved with chemotherapy and the pluridisciplinar treatment.