[Organ defects due to cancer treatment in infancy and childhood]

In infancy and childhood, as in adults, organ defect is the most direct adverse effect of cancer treatment. Anatomical defects due to surgical treatment and functional defects due to radiotherapy are the two main types. In this paper, the relationship between the radicality of surgical treatment and preservation of organ form and function are discussed with regard to the thyroid, chest wall, lung, stomach, intestine, liver, pancreas, kidney and intra-pelvic organs. The more radical the treatment, the less preservation of organ form and function. The role of surgery has been changing in accordance with the development of chemotherapeutic drugs and drug combination, and must always be reevaluated in accordance with any progress made in other treatment modalities. Some typical cases from a series of patients we have treated were presented. A neonatal case of broad right chest wall defect due to surgical removal of chondroblastoma was presented, showing our new method of chest wall reconstruction. A case of bilateral Wilms' tumor was presented, which was treated using bench surgery to prevent total removal of kidney tissue. A case of huge and infiltrative intra-pelvic rhabdomyosarcoma was also described, which was treated by tumor extirpation and 2/3 partial resection of the urinary bladder, in combination with chemotherapy and radiotherapy.