Impact of neoadjuvant chemotherapy on tumour volume in unilateral Wilms tumour histotypes: a retrospective study

Abstract Background Wilms tumour (WT), the most common paediatric kidney tumour, is treated in Morocco following the SIOP protocol, which practices neoadjuvant chemotherapy (NAC). The response to NAC can be assessed by considering both tumor volume reduction and the proportion of therapy-induced cha...

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Main Authors: Sara Benlhachemi, Mohammed Khattab, Kenza Hattoufi, Redouane Abouqal, Elmostafa El fahime
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14177-x
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author Sara Benlhachemi
Mohammed Khattab
Kenza Hattoufi
Redouane Abouqal
Elmostafa El fahime
author_facet Sara Benlhachemi
Mohammed Khattab
Kenza Hattoufi
Redouane Abouqal
Elmostafa El fahime
author_sort Sara Benlhachemi
collection DOAJ
description Abstract Background Wilms tumour (WT), the most common paediatric kidney tumour, is treated in Morocco following the SIOP protocol, which practices neoadjuvant chemotherapy (NAC). The response to NAC can be assessed by considering both tumor volume reduction and the proportion of therapy-induced changes observed in histological specimens, including necrosis. This retrospective study assesses the impact of NAC on tumour volume across various WT histotypes and correlates these changes with proportions of therapy-induced necrosis. Methods We analysed imaging data and anatomopathological reports, before and after NAC, of 56 patients with unilateral WT, admitted to the children’s hospital in Rabat, from January 2014 to February 2018. Results NAC significantly reduced tumour volume in 82% of WT cases, with an average decrease of 65% in tumour size, with a p < 0.001. Notably, the regressive, blastemal, and mixed types exhibited the most significant response to NAC, in 94%, 82%, and 92% of cases, with p < 0.001, 0.010, 0.002, respectively. The epithelial type showed a decrease in tumour volume in 73% of cases, with p = 0.041. Whereas, the stromal type did not exhibit a significant decrease in tumour volume following NAC (p = 0.790). Moreover, tumor volume decreased by 43% in one case with focal anaplasia and blastemal type, but increased by 7% in the other case with focal anaplasia and regressive type. The change in tumour volume and necrosis demonstrates a moderate negative correlation (Rho = -0.428; p < 0.001). An increase in the proportion of necrosis is associated with a decrease in tumor volume. Conclusion Our findings show a significant reduction in tumour size following NAC in all WT histotypes, with the exception of the stromal type, suggesting the need for alternative strategies, such as intensified treatment or initial nephrectomy for operable tumours.
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spelling doaj-art-3a3f7409b2fa4ca3a0c364c2f29818bb2025-08-20T03:38:18ZengBMCBMC Cancer1471-24072025-07-0125111210.1186/s12885-025-14177-xImpact of neoadjuvant chemotherapy on tumour volume in unilateral Wilms tumour histotypes: a retrospective studySara Benlhachemi0Mohammed Khattab1Kenza Hattoufi2Redouane Abouqal3Elmostafa El fahime4Mohammed VI University of Health Sciences (UM6SS)Department of Paediatric Haematology and Oncology, Abulcasis International University of Health SciencesDepartment of Neonatology and Nutrition, University Hospital Centre, IBN SINABiostatistics Laboratory, Clinical Epidemiology Research. Faculty of Medicine and Pharmacy, Mohammed V University in RabatMohammed VI University of Health Sciences (UM6SS)Abstract Background Wilms tumour (WT), the most common paediatric kidney tumour, is treated in Morocco following the SIOP protocol, which practices neoadjuvant chemotherapy (NAC). The response to NAC can be assessed by considering both tumor volume reduction and the proportion of therapy-induced changes observed in histological specimens, including necrosis. This retrospective study assesses the impact of NAC on tumour volume across various WT histotypes and correlates these changes with proportions of therapy-induced necrosis. Methods We analysed imaging data and anatomopathological reports, before and after NAC, of 56 patients with unilateral WT, admitted to the children’s hospital in Rabat, from January 2014 to February 2018. Results NAC significantly reduced tumour volume in 82% of WT cases, with an average decrease of 65% in tumour size, with a p < 0.001. Notably, the regressive, blastemal, and mixed types exhibited the most significant response to NAC, in 94%, 82%, and 92% of cases, with p < 0.001, 0.010, 0.002, respectively. The epithelial type showed a decrease in tumour volume in 73% of cases, with p = 0.041. Whereas, the stromal type did not exhibit a significant decrease in tumour volume following NAC (p = 0.790). Moreover, tumor volume decreased by 43% in one case with focal anaplasia and blastemal type, but increased by 7% in the other case with focal anaplasia and regressive type. The change in tumour volume and necrosis demonstrates a moderate negative correlation (Rho = -0.428; p < 0.001). An increase in the proportion of necrosis is associated with a decrease in tumor volume. Conclusion Our findings show a significant reduction in tumour size following NAC in all WT histotypes, with the exception of the stromal type, suggesting the need for alternative strategies, such as intensified treatment or initial nephrectomy for operable tumours.https://doi.org/10.1186/s12885-025-14177-xWilms tumour (WT)Neoadjuvant chemotherapyTumour volumeWT histotypesNecrosisSIOP protocol
spellingShingle Sara Benlhachemi
Mohammed Khattab
Kenza Hattoufi
Redouane Abouqal
Elmostafa El fahime
Impact of neoadjuvant chemotherapy on tumour volume in unilateral Wilms tumour histotypes: a retrospective study
BMC Cancer
Wilms tumour (WT)
Neoadjuvant chemotherapy
Tumour volume
WT histotypes
Necrosis
SIOP protocol
title Impact of neoadjuvant chemotherapy on tumour volume in unilateral Wilms tumour histotypes: a retrospective study
title_full Impact of neoadjuvant chemotherapy on tumour volume in unilateral Wilms tumour histotypes: a retrospective study
title_fullStr Impact of neoadjuvant chemotherapy on tumour volume in unilateral Wilms tumour histotypes: a retrospective study
title_full_unstemmed Impact of neoadjuvant chemotherapy on tumour volume in unilateral Wilms tumour histotypes: a retrospective study
title_short Impact of neoadjuvant chemotherapy on tumour volume in unilateral Wilms tumour histotypes: a retrospective study
title_sort impact of neoadjuvant chemotherapy on tumour volume in unilateral wilms tumour histotypes a retrospective study
topic Wilms tumour (WT)
Neoadjuvant chemotherapy
Tumour volume
WT histotypes
Necrosis
SIOP protocol
url https://doi.org/10.1186/s12885-025-14177-x
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