Wilms' tumor: a 24-year retrospective study from a single center

Area of Science:

• Pediatric Oncology
• Pediatric Surgery
• Medical Imaging

Background:

• Wilms tumor is a significant pediatric kidney cancer.
• Understanding its clinical presentation and treatment outcomes is vital for improving patient care.

Purpose of the Study:

• To analyze the clinical characteristics, diagnostic methods, and treatment outcomes of Wilms tumor in a pediatric cohort.
• To evaluate the effectiveness of surgical and chemotherapeutic interventions.

Main Methods:

• Retrospective review of medical records for 71 children diagnosed with Wilms tumor between 1990 and 2014.
• Analysis of clinical manifestations, diagnostic imaging (Ultrasound, Doppler USG), surgical procedures (nephrectomy, nephron sparing surgery), and preoperative chemotherapy.
• Evaluation of patient follow-up data, including metastases and mortality.

Main Results:

• The mean age at diagnosis was 3.11 years, with a M/F ratio of 6/10.
• Abdominal mass (89%) was the most frequent clinical manifestation.
• Left kidney involvement (46.5%) was slightly more common than right kidney involvement (43.7%). Bilateral involvement was observed in 7.04% of cases.
• Unilateral radical nephrectomy was performed in 63 patients, while nephron sparing surgery was utilized in cases of solitary or bilateral tumors.
• Out of 71 patients, 17 were lost to follow-up, 4 died, and 10 developed metastases; 40 children remain under follow-up without metastases.

Conclusions:

• Wilms tumor management requires a multimodal, multidisciplinary approach involving pediatric oncologists and surgeons.
• Close patient follow-up is essential for monitoring treatment response and detecting potential recurrence or metastases.
• Diagnostic imaging, particularly ultrasound, plays a key role in the initial evaluation of suspected Wilms tumor.