Analysis Of The Outcome Of Nephron Sparing Surgery In Bilateral Wilms Tumor

Purpose: To evaluate our clinical experience with nephron sparing surgery(NSS)for bilateral Wilms tumor.Methods: Medical records of children with bilateral Wilms tumor undergoing NSS in the Children’s Hospital of Chongqing Medical University during a 15-year period were retrospectively analyzed.Data collected were composed of age at surgery,tumor response,pathology reports,renal function,and patient survival.Results: A total of 18 eligible patients(10 males,8 females)with bilateral Wilms tumor at a mean age of 2.28 ± 1.12 years were identified.The administration of preoperative chemotherapy did not result in universally successful outcomes.All children underwent successfully unilateral or bilateral NSS.The pathological study showed favorable histology and unfavorable histology in 32 and 4 kidneys,respectively.The4-year event-free survival and overall survival rates were 68.18% and85.56%.In univariable analysis,tumor histology(p = 0.0028)and disease stage(p = 0.0303)appeared significantly associated with overall survival.After a median follow-up period of 41.5 months(range,10-89),three of thesurviving patients were diagnosed with hypertension and one had renal insufficiency.Conclusions: Our experience suggests that NSS has become a feasible and effective option with good oncologic outcomes.Further researches,ideally in a multicenter randomized manner,are warranted to better determine the role of NSS in this challenging clinical scenario.