Bilateral Wilms tumor: an eleven year experience

Area of Science:

• Pediatric Oncology
• Nephrology
• Genitourinary Pathology

Background:

• Wilms tumor is a common pediatric kidney cancer.
• Bilateral Wilms tumors (BWT) present unique treatment challenges.
• Treatment outcomes for BWT have historically been variable.

Purpose of the Study:

• To evaluate treatment outcomes for patients with bilateral Wilms tumors.
• To highlight the role of salvage chemotherapy and DNA ploidy in BWT management.
• To assess the efficacy of renal conservation surgeries in BWT.

Main Methods:

• Retrospective review of 111 Wilms tumor cases, focusing on 7 with BWT.
• Analysis of treatment protocols, including salvage chemotherapy regimens (Cisplatin, Ifosphamide, VP-16).
• Flow cytometric DNA ploidy analysis performed on a subset of BWT cases.

Main Results:

• Three of five evaluable BWT patients achieved survival, with one cured despite metastatic disease.
• Salvage chemotherapy regimens contributed to successful treatment outcomes.
• DNA ploidy analysis indicated aneuploidy in two of three BWT cases.

Conclusions:

• Bilateral Wilms tumors can achieve high cure rates with aggressive management.
• Renal conservation surgery and effective chemotherapy, including salvage regimens, are crucial for BWT.
• DNA ploidy may serve as a prognostic marker in BWT, warranting further investigation.