Surgery in Bilateral Wilms Tumor-A Single-Center Experience

• Main Authors: Fernanda Kelly Marques de Souza (Author), Mayara Caroline Amorim Fanelli (Author), Alexandre Alberto Barros Duarte (Author), Maria Teresa de Seixas Alves (Author), Henrique Manoel Lederman (Author), Monica dos Santos Cypriano (Author), Simone de Campos Vieira Abib (Author)
• Format: Book
• Published: MDPI AG, 2023-11-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3390/children10111790; 2227-9067
• Keywords: bilateral Wilms tumor; nephron-sparing surgery; renal tumor; renal surgery; Pediatrics; RJ1-570
• Source: Children, Vol 10, Iss 11, p 1790 (2023)

The treatment of bilateral Wilms tumors (BWT) involves curing the cancer, preserving long-term renal function, and maintaining a good quality of life. Established methods for achieving these goals include preoperative chemotherapy and nephron-sparing surgery (NSS). This study aimed to evaluate the experience of a single institution in treating patients with BWT. We analyzed cases of BWT treated at the Pediatric Oncology Institute-GRAACC-Federal University of São Paulo over a period of 35 years. Bleeding control was performed with manual compression of the renal parenchyma. Thirty-three patients were included in the study. Thirty cases were synchronous tumors. The mean age at diagnosis was 30.4 months (±22 m) and 66.7% were girls. The median follow-up period was 83 months. Neoadjuvant chemotherapy was the primary approach in most patients (87.9%), with a simultaneous upfront surgical approach performed in 84.8%. Most patients underwent bilateral NSS (70.4%). There were no early complications in this series, but 39.4% had clinical complications. The five-year survival rate was 76%. Therefore, it is clear that the surgical approach to BWT plays a crucial role in achieving good outcomes. However, it is difficult to standardize surgical techniques and technology may have the potential to enhance safety.