Nephron Sparing Surgery (NSS) for Unilateral Wilms Tumor (UWT): The SIOP 2001 Experience

摘要: Background Total nephrectomy (TN) remains the standard treatment of unilateral Wilms tumors (uWT). The SIOP WT-2001 protocol allowed Nephron Sparing Surgery (NSS) for polar or peripherally non-infiltrating tumors. Aim: Inventory current NSS-experience. Procedures 2,800 patients with a unilateral, localized metastatic and an unequivocal surgical technique recorded were included. All had neo-adjuvant chemotherapy delayed surgery. In 91 (3%) NSS was performed in 2709 TN. Data retrieved from WT 2001 database. Results NSS group contained 65% stage I tumours TN 48%. Tumor volume (at diagnosis surgery) significantly smaller group. Within III, after NSS, 7/12 (58%) positive margins (M +), 5 tumor negative lymph nodes (LN-). After TN, 355/712 (55%) M + , 182 LN-. Treatment M+ resulted two conversions to (one combined radiotherapy), three radiotherapy only local therapy, if given, not recorded. four recurrences occurred. For disease 5-year overall (OS) event free survival (EFS) 100 94.8 (95% CI:89.9-99.9), respectively, while OS EFS 94.4 CI: 93.2-95.5, log-rank test P = 0.06) 86.5 CI:85.0-88.1, P = 0.06), respectively. Conclusions NSS 3% uWT. Despite excellent few relapses, gain nephrons needs be weighed against risk induce III intensified therapy. Pediatr Blood Cancer 2014;61:2175–2179. © 2014 Wiley Periodicals, Inc.