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Related Experiment Videos

Bilateral Wilms' tumor.

O P Tucker, C W McGill, W J Pokorny

    Journal of Pediatric Surgery
    |December 1, 1986
    PubMed
    Summary
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    Bilateral Wilms' tumor treatment shows promising outcomes with organ-sparing approaches. Early results suggest chemotherapy and staged surgical procedures can preserve renal tissue in pediatric patients.

    Area of Science:

    • Pediatric Oncology
    • Nephrology
    • Surgical Oncology

    Background:

    • Bilateral Wilms' tumor, a rare pediatric malignancy, presents unique treatment challenges.
    • Historically, treatment often involved radical nephrectomy, impacting renal function.
    • Recent trends favor organ-sparing strategies for improved long-term outcomes.

    Purpose of the Study:

    • To evaluate the outcomes of treating bilateral Wilms' tumor using a combination of chemotherapy and surgical interventions.
    • To assess the feasibility and efficacy of nephron-sparing techniques in managing bilateral Wilms' tumor.
    • To explore the potential of multi-stage treatment protocols for preserving renal function.

    Main Methods:

    • Retrospective analysis of ten pediatric patients diagnosed with bilateral Wilms' tumor between 1971 and 1985.

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  • Treatment modalities included nephrectomy, partial nephrectomy, and a more recent approach involving biopsy, chemotherapy, and second-look/third-look procedures.
  • Histopathological review and survival data were collected and analyzed.

    • Main Results:

    • Nine out of ten patients had favorable histology; one had mixed histology.
    • Eight patients survived with follow-up ranging from 6 months to 13 years.
    • Two patients with extensive disease died within 16 months.
    • Organ-sparing approaches, including bilateral partial nephrectomies and chemotherapy-based protocols, demonstrated positive results.

    Conclusions:

    • Organ-sparing surgery and neoadjuvant chemotherapy followed by staged procedures are effective in treating bilateral Wilms' tumor.
    • These approaches can lead to the preservation of functioning renal tissue.
    • Multi-stage treatment strategies offer a favorable outlook for patients with bilateral Wilms' tumor, improving survival and renal function preservation.