Surgery in Bilateral Wilms Tumor-A Single-Center Experience

Area of Science:

• Pediatric Oncology
• Surgical Oncology
• Nephrology

Background:

• Bilateral Wilms tumors (BWT) present unique challenges in pediatric oncology.
• Treatment aims to cure cancer, preserve renal function, and maintain quality of life.
• Nephron-sparing surgery (NSS) and preoperative chemotherapy are established treatment modalities.

Purpose of the Study:

• To evaluate a single institution's 35-year experience in treating pediatric patients with BWT.
• To assess the outcomes of neoadjuvant chemotherapy and bilateral NSS in BWT management.
• To identify factors influencing survival and complications in BWT treatment.

Main Methods:

• Retrospective analysis of 33 BWT cases treated at a single pediatric oncology center over 35 years.
• Review of treatment approaches including neoadjuvant chemotherapy and surgical interventions.
• Evaluation of patient demographics, treatment details, complications, and survival rates.

Main Results:

• The majority of patients (87.9%) received neoadjuvant chemotherapy, with 84.8% undergoing upfront surgery.
• Bilateral NSS was performed in 70.4% of patients.
• The five-year survival rate was 76%, with 39.4% experiencing clinical complications.

Conclusions:

• The surgical approach is critical for successful BWT treatment outcomes.
• While NSS is frequently employed, standardization of surgical techniques remains a challenge.
• Technological advancements may offer potential for enhanced safety in BWT surgery.