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[Bilateral Wilms' tumour. Results of treatment in 29 children]
Krystyna Sawicz-Birkowska1, Wojciech Apoznanski, Bozenna Dembowska-Bagińska
1Katedra i Klinika Chirurgii i Urologii Dzieciecej, Akademia Medyczna, ul. Skłodowskiej-Curie 50/52, 50-369 Wrocław, Poland. sawicz@chir.dz.wroc.pl
Insights
This study analyzed 29 children with bilateral Wilms
Area of Science:
- Pediatric Oncology
- Nephroblastoma Research
Context:
- Retrospective analysis of 29 children diagnosed with bilateral Wilms' tumour.
- Patients aged 4 months to 5 years, treated under the O1-92 PPGL Protocol in Poland.
- Utilized preoperative chemotherapy regimens including ACT, Vincristine (VCR), and Doxorubicin (DOX).
Purpose:
- To evaluate the outcomes of neoadjuvant chemotherapy and surgical interventions for bilateral Wilms' tumour.
- To assess the feasibility of kidney-sparing surgery in this pediatric patient cohort.
- To determine the event-free survival (EFS) rates in children with bilateral Wilms' tumour.
Summary:
- 26 patients underwent surgery post-cytoreductive chemotherapy; 12 had nephrectomy, while 28 had successful kidney-sparing procedures.
- 19 out of 29 patients (65.5%) survived, including one with residual nephroblastoma.
- Kaplan-Meier analysis indicated an EFS of 58% at 67 months for the studied group.
Impact:
- Demonstrates the effectiveness of neoadjuvant chemotherapy and tailored surgical approaches in managing bilateral Wilms' tumour.
- Highlights the high success rate of kidney-sparing surgery, preserving renal function in pediatric patients.
- Provides valuable data on long-term outcomes and survival rates for this rare presentation of Wilms' tumour.
Abstract:
Retrospective analysis of 29 children with bilateral Wilms' Tumour, 14 boys and 15 girls, aged 4m-5 years, from regional centres of paediatric oncology in Poland, treated according to the O1-92 PPGL Protocol of Wilms' tumour, was performed. All patients were treated with two (ACT + VCR) or three (ACT, VCR, DOX) cytostatic drugs preoperatively, and 26 were operated upon after cytoreductive pretreatment. In 12 children nephrectomy was performed. In 28, kidney sparing surgery was possible and made with success. 2 patients who presented disseminated disease and 1 with nephroblastomatosis were given chemotherapy. 19 out of 29 (65.5%) are alive including 1 patient with nephroblastoma. EFS calculated according to Kaplan-Meier analysis for this group, was 58% at 67 months.
