Multi-center study of wilms tumors treated by different therapeutic strategies in two different countries

According to the treatment of Wilims' tumours', two different therapeutic strategies were established in the 2[nd] half of the last century. Both NWTS and SIOP have helped to improve the clinical management and outcome of Wilms' tumour's patients. In this study we compared the 3 groups of Wilms' tumour patients with different racial backgrounds and therapeutic strategies. Clinicopathological review was performed for 40 patients treated at Kyushu University [KU] hospital in Japan from 1960 to 2006 according to NWTS and JWiTS [Japanese Wilms' tumour Study] protocols, and 79 patients treated at South Egypt Cancer Institute [SECI] from 2002 to 2009 according to SIOP protocol. Retrospective study of 33 patients treated at pediatric surgery department of Assiut University hospital, from 2000 to 2009 according to NWTS protocol In KU group, a favourable histology [FH] was diagnosed in 82.5% and an unfavourable histology [UH] in 17.5%. Distribution of the clinical stage: I = 40%, II = 22.5%, III = 22.5%, IV = 7.5%, V = 7.5%. Five year overall survival was 82.5% and 5 year stage related survival was as follows; I 93.7%, II 83.3%, III 62.5%, IV 33.3% and V 100%. In SECI group, FH was diagnosed in 89.9%, UH in 8.8% and benign disease in 1.3%. Distribution of the clinical stage [pre and post chemotherapy] was as follows: I = 25.3% 50%, II =19% 20%, III = 35.4 15%, IV = 12.5% 5%, V =7.6% 7.6%. No case of intra-operative tumour rupture was recorded. The overall 5 year survival rate 80% with 5 year stage related survival was as follows; 195%, 11 93%, III 75%, IV 50% and V 83%. In AU group a favourable histology [FH] was diagnosed in 79% and an unfavourable histology [UH] in 9%. Distribution of the clinical stage: I = 39.4%, II = 21.2%, III = 21.2%, IV = 12%, V = 6%. The overall 5 years survival rate was 78.8% and 5 year stage related survival was as follows; 192%, 11 86%, III 71%, IV 50% and V 50%. The KU and AU group results proved the advantages of primary surgery in which accurate staging information and unmodified tumour histology helped subsequent treatment by proper chemotherapy dose. The SECI group results proved that preoperative chemotherapy increased the rate of stage I disease and decreasing the incidence of intraoperative tumour rupture. However, there was a possibility that chemotherapy administered to benign disease or an inappropriately low dose led to unfavourable histology

Role of fluconazole prophylaxis in decreasing Candida infection and colonization among severely neutropenic children with hematological malignancies

To Assess the role of antifungal prophylaxis in decreasing Candida infection and colonization in severely neutropenic children with hematological malignancies. Sixty four patients with severe neutropenia are randomized equally into 2 groups on 1:1 basis either to receive fluconazole prophylaxis [study group], or to receive placebo [control group]. Fluconazole antifungal prophylaxis/ placebo It was continued for 6 weeks, and follow up of the patient done until either Prophylaxis success by recovery from severe neutropenia [ANC