The aim of the study was to define the role of presence of IDRF related to kidneys in evaluation of the risk of kidneys function disturbance after surgery in children with neuroblastoma.
From 2002–2015, 95 patients with neuroblastoma stage 2-4 were treated in the Department of Pediatric Oncology and Hematology, Institute of Pediatrics in Krakow; 71 with tumors in abdomen had tumors removed in the Department of Pediatric Surgery. In all patients with abdomen tumor, imaging performed before surgery was analyzed for the presence of IDRF.
In 21 children (30%), IDRF defined as renal pedicle infiltration and/or infiltration of one or both kidneys were present at presurgical imaging. In this group, kidneys in post-operative imaging as well as GFR were evaluated and compared with the GFR results in children with other tumor localization or abdominal tumors without IDRF related to kidneys.
In 5/21 (24%) children the postoperative kidneys dysfunction was found. Ischemic lesions were found on control post-operative imaging, described as partial (n=3) or total (n=2) kidneys dysfunction. In 1 child it was necessary to remove the kidney after chemotherapy because of uncontrolled hypertension with the loss of kidney function. In this group, if kidneys dysfunction was described in post-operative imaging, GFR was lower than in children without any pathologies at this time. Present IDRF related to kidneys may predict the increased risk of increased GFR after surgery.
Conclusions: IDRF evaluation before surgery is helpful in predicting the risk and avoiding of post-surgical kidneys dysfunction, also in patients without obvious kidneys injury during surgery. It is especially important in high risk patient, in whom the kidney function has the crucial meaning for the course of further therapy.