PURPOSE: Nephrectomy with lymph node sampling is the recommended treatment for children with unilateral Wilms tumor under the Children's Oncology Group protocols.
Using radiological assessment, we determined the feasibility of performing partial nephrectomy in a select group of patients with very low risk unilateral Wilms tumor.
MATERIALS AND METHODS: We reviewed imaging studies of 60 patients with a mean age of less than 2 years with very low risk unilateral Wilms tumor (mean weight less than 550 gm) to assess the feasibility of partial nephrectomy. We evaluated percentage of salvageable parenchyma, tumor location and anatomical features preventing a nephron sparing approach.
RESULTS: A linear relationship exists between tumor weight and computerized tomography estimated tumor volume. Mean tumor weight in the study population was 315 gm. Partial nephrectomy was deemed feasible in only 5 of 60 patients (8%).
CONCLUSIONS: When considering a select population with very low risk unilateral Wilms tumor (lower volume tumor), only a small percentage of nonpretreated patients are candidates for nephron sparing surgery.
Written by:
Ferrer FA, Rosen N, Herbst K, Fernandez CV, Khanna G, Dome JS, Mullen E, Gow KW, Barnhart DC, Shamberger RC, Ritchey M, Ehrlich P. Are you the author?
Division of Pediatric Urology, Connecticut Children's Medical Center, Hartford, Connecticut.
Reference: J Urol. 2013 May 30. pii: S0022-5347(13)04513-8.
doi: 10.1016/j.juro.2013.05.060
PubMed Abstract
PMID: 23727411
UroToday.com Renal Cancer Section
