ABSTRACT
BACKGROUND: Genitourinary tract tumors in children are less common than in adults. Most of these tumors have different genetic backgrounds, clinical presentation, and oncologic behavior than their adult counterpart. As a result of low prevalence in children, some of the treatment approaches and recommendations are based on treatment experience in adult patients. However, thanks to scientific and technological development, survival rates have risen considerably. OBJECTIVE: This paper presents a review of the principal features of the tumors involving the genitourinary tract in children and an update in genetic background, diagnosis, and treatment. METHODS: A narrative review was performed on published literature about genitourinary tract tumors in pediatric patients. Papers presented in English and Spanish literature were reviewed. PubMed, Science Direct, and SciELO databases were used to collect information and present this article. RESULTS: Kidney tumors are the most common type of genitourinary tumors in children. Among those, Wilms tumor represents the majority of cases and shows the successful work of clinical trial groups studying this tumor type. Other tumors involving the genitourinary tract in children include Rhabdomyosarcoma, Transitional cell carcinoma, Testicular, and Adrenal tumors. CONCLUSION: Genitourinary tract tumors in children represent significant morbidity and economic burden, so awareness in early diagnosis represents improvement in treatment, clinical, and oncological outcomes.
Subject(s)
Kidney Neoplasms , Rhabdomyosarcoma , Testicular Neoplasms , Urogenital Neoplasms , Wilms Tumor , Child , Humans , Kidney Neoplasms/diagnosis , Kidney Neoplasms/genetics , Kidney Neoplasms/pathology , Male , Rhabdomyosarcoma/diagnosis , Rhabdomyosarcoma/pathology , Rhabdomyosarcoma/therapy , Testicular Neoplasms/diagnosis , Testicular Neoplasms/pathology , Testicular Neoplasms/therapy , Urogenital Neoplasms/diagnosis , Urogenital Neoplasms/genetics , Urogenital Neoplasms/therapy , Wilms Tumor/geneticsABSTRACT
The management of genitourinary cancer, including bladder, prostate, renal and testicular cancer, has evolved dramatically in recent years due to a better understanding of tumour genetic mutations, alterations in molecular pathways, and to the development of new kinds of drugs such as targeted therapies and immunotherapies. In the field of immunotherapy, new drugs focused on stimulating, enhancing and modulating the immune system to detect and destroy cancer, have been recently discovered. Research in oncology moves quickly and new data of great relevance for clinical practice are communicated every year. For this reason, a group of experts, focused exclusively on the treatment of genitourinary tumours and who get together every year in the BestGU conference to assess the latest progress in this field have summarized the most important advances in a single review, along with a critical assessment of whether these results should alter daily clinical practice.
Subject(s)
Urogenital Neoplasms/genetics , Urogenital Neoplasms/therapy , Antineoplastic Agents/therapeutic use , Clinical Trials as Topic , Cystectomy , Drugs, Investigational/therapeutic use , Female , Humans , Immunotherapy/methods , Immunotherapy/trends , Kidney Neoplasms/genetics , Kidney Neoplasms/therapy , Male , Molecular Targeted Therapy/methods , Mutation , Neoadjuvant Therapy , Neoplasm Recurrence, Local/therapy , Neoplasms, Germ Cell and Embryonal/genetics , Neoplasms, Germ Cell and Embryonal/therapy , Nephrectomy , Prostatic Neoplasms/genetics , Prostatic Neoplasms/therapy , Urinary Bladder Neoplasms/genetics , Urinary Bladder Neoplasms/therapyABSTRACT
We integrated all the eligible studies and investigated whether the TNF-α 308G/A polymorphism correlates with urogenital cancer risk. Tumor necrosis factor-α (TNF-α) is a risk factor for some urogenital cancers; however, in prostate and bladder cancers the results are controversial. PubMed, EMBASE, Web of Science, the Cochrane Library, the Chinese Biomedical Literature Database, and the Wanfang Database were searched for all case-control studies on the relationship between the TNF-α 308G/A polymorphism and susceptibility to urogenital cancer between January 1994 and January 2015. The pooled odds ratio with 95% confidence interval was calculated to assess the associations. A total of 504 articles were found, 39 of which involved 11,613 cases and 12,542 controls that fulfilled the inclusion criteria. Overall, the TNF-α 308G/A polymorphism was significantly associated with the risk of urogenital cancer. In the subgroup analysis for different cancer types, significant associations were found in cervical cancer and urothelial carcinoma, while our meta-analysis indicated that there were no significant associations between the TNF-α 308G/A polymorphism and prostate, bladder, or renal cancers. When stratified by ethnicity, significant associations were observed in Caucasian populations, whereas no significant associations were found in African-Americans, Asians, or mixed populations. Furthermore, carriers of the -308A allele among the hospital-based case-control group were at a high risk of urogenital cancer. Our meta-analysis showed that the TNF-α 308G/A polymorphism was significantly associated with urogenital cancer risk, particularly in the Caucasian and hospital-based populations.
Subject(s)
Alleles , Genetic Association Studies , Genetic Predisposition to Disease , Polymorphism, Single Nucleotide , Tumor Necrosis Factor-alpha/genetics , Urogenital Neoplasms/epidemiology , Urogenital Neoplasms/genetics , Case-Control Studies , Female , Gene Frequency , Genotype , Humans , Male , Odds Ratio , Publication Bias , RiskABSTRACT
La mayoría de los casos de manifestaciones malignas en el tracto genitourinario en la edad pediátrica son esporádicos siendo la neoplasia más frecuente, el tumor de Wilms'. De todos modos una minoría de los casos tienen una asociación a síndromes genéticos causados por la mutación de uno o más genes. Es por esto, la importancia de conocer las diferentes asociaciones y sus manifestaciones clínicas con el fin de identificar oportunamente las diferentes patologías para así tratarlas adecuadamente