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Related Experiment Videos

Bilateral Wilms tumor.

M L Blute1, P P Kelalis, K P Offord

  • 1Mayo Clinic, Rochester, Minnesota 55905.

The Journal of Urology
|October 1, 1987
PubMed
Summary
This summary is machine-generated.

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Synchronous bilateral Wilms tumor treatment shows a 76% survival rate. Chemotherapy is emphasized, with initial biopsy and chemotherapy showing promise for renal preservation in pediatric cancer patients.

Area of Science:

  • Pediatric Oncology
  • Nephrology
  • Surgical Oncology

Background:

  • Synchronous bilateral Wilms tumor (SBWT) presents unique treatment challenges.
  • Institutional variations exist in managing SBWT, impacting outcomes.
  • National Wilms Tumor Studies 2 and 3 provide data on SBWT management.

Purpose of the Study:

  • To evaluate treatment strategies and outcomes for synchronous bilateral Wilms tumor.
  • To identify prognostic factors influencing survival in SBWT patients.
  • To guide future treatment recommendations for SBWT.

Main Methods:

  • Review of 145 patients with stage V disease (SBWT) from National Wilms Tumor Studies 2 and 3.
  • Comparison of outcomes between initial surgical resection and initial biopsy with chemotherapy/second-look surgery.

Related Experiment Videos

  • Analysis of prognostic factors including age, stage, histology, and nodal involvement.

    • Main Results:

    • Overall 3-year survival rate of 76% achieved for SBWT.
    • Initial surgery followed by chemotherapy yielded an 82% 3-year survival rate.
    • Initial biopsy with chemotherapy and second-look surgery showed a 57% 3-year survival rate.
    • Only 38% of patients achieved complete tumor resection.
    • Unfavorable histology occurred in 10% of patients; 4% had discordant histology.

    Conclusions:

    • Chemotherapy is increasingly emphasized as a primary treatment modality for SBWT.
    • Routine bilateral biopsy followed by chemotherapy is recommended.
    • Prognostic factors like younger age, lower stage, favorable histology, and negative nodes improve outcomes.
    • Treatment aims for tumor shrinkage to facilitate renal preservation (biopsy/partial nephrectomy).