Portal de Periódicos da CAPES

Partial Nephrectomy for Unilateral Wilms Tumor: Results of Study SIOP 93–01/GPOH

2003; Lippincott Williams & Wilkins; Volume: 170; Issue: 3 Linguagem: Inglês

10.1097/01.ju.0000073848.33092.c7

1527-3792

Frank-Martin Haecker, Dietrich von Schweinitz, D. Harms, D. Buerger, Norbert Graf,

Renal cell carcinoma treatment

No AccessJournal of UrologyPEDIATRIC UROLOGY1 Sep 2003Partial Nephrectomy for Unilateral Wilms Tumor: Results of Study SIOP 93–01/GPOH FRANK-MARTIN HAECKER, DIETRICH von SCHWEINITZ, DIETER HARMS, DIETRICH BUERGER, and NORBERT GRAF FRANK-MARTIN HAECKERFRANK-MARTIN HAECKER , DIETRICH von SCHWEINITZDIETRICH von SCHWEINITZ , DIETER HARMSDIETER HARMS , DIETRICH BUERGERDIETRICH BUERGER , and NORBERT GRAFNORBERT GRAF View All Author Informationhttps://doi.org/10.1097/01.ju.0000073848.33092.c7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluate results and long-term outcome after partial nephrectomy (PN) for unilateral Wilms tumor (ulWT) in relation to different histological features, performed as initial surgery or after induction chemotherapy (ChT). Materials and Methods: Data from patients with ulWT who had undergone PN in the German Study SIOP 93–01/GPOH were analyzed for time of surgery in the treatment schedule, postoperative stage, histological features, surgical radicality and outcome. The results were correlated with overall survival and relapse-free survival, and compared with those of patients who had undergone total tumor nephrectomy (TN). Results: A total of 770 patients underwent TN and 37 underwent PN, of which 766 (99.5%) and 36 (97.3%), respectively, were radical procedures. A total of 139 TNs and 15 PNs were performed at primary surgery, 630 TNs and 22 PNs after ChT, and 1 TN after irradiation. Two of 15 patients following primary PN and 1 of 22 following delayed PN had local recurrence. Two patients died of metastatic disease. Tumor stage, overall survival of 93% and relapse-free survival of 88% were equal after PN and TN in analysis of the whole group. This was also true for patients with surgery after ChT. One of 2 patients with histologically unfavorable disease had relapse after PN compared to only 3 of 35 patients with histologically low or intermediate risk disease. Conclusions: PN should be performed only for small, histologically low or intermediate risk tumors after good response to ChT to secure a complete resection. References 1 : Results of the Sixth International Society of Pediatric Oncology Wilms' Tumor Trial and Study: a risk-adapted therapeutic approach in Wilms' tumor. J Clin Oncol1993; 11: 1014. Google Scholar 2 : Renal function up to 50 years after unilateral nephrectomy in childhood. Am J Kidney Dis1993; 21: 603. Google Scholar 3 : Kidney function in adults born with unilateral agenesis or nephrectomized in childhood. Pediatr Nephrol1988; 2: 177. Google Scholar 4 : Renal salvage procedures in patients with synchronous bilateral Wilms' tumors: a report from the National Wilms' Tumor Study Group. J Pediatr Surg1996; 31: 1020. Google Scholar 5 : Conservative surgical management of bilateral Wilms tumor: results of the United Kingdom Children's Cancer Study Group. J Urol1998; 160: 1450. Link, Google Scholar 6 : Is partial nephrectomy appropriate treatment for unilateral Wilms' tumor?. J Pediatr Surg1998; 33: 165. Google Scholar 7 : Enucleative surgery for stage I nephroblastoma with a normal contralateral kidney. J Urol1996; 156: 1788. Link, Google Scholar 8 : The new SIOP (Stockholm) working classification of renal tumours of childhood. International Society of Paediatric Oncology. Med Pediatr Oncol1996; 26: 145. Crossref, Medline, Google Scholar 9 : The role of preoperative chemotherapy in the management of Wilms' tumor. The SIOP studies International Society of Pediatric Oncology. Urol Clin North Am2000; 27: 443. Google Scholar 10 : Controversies in the management of Wilms' tumor. Semin Pediatr Surg2001; 10: 127. Google Scholar 11 : Renal functional reserve in long-term survivors of unilateral Wilms tumor. J Pediatr1991; 118: 698. Google Scholar 12 : Feasibility of partial nephrectomy for Wilms' tumor in children with Beckwith-Wiedemann syndrome who have been screened with abdominal ultrasonography. J Pediatr Surg2002; 37: 57. Google Scholar 13 : Renal failure in Wilms' tumor patients: a report from the National Wilms' Tumor Study Group. Med Pediatr Oncol1996; 26: 75. Google Scholar 14 : The role of renal salvage procedures for bilateral Wilms' tumor: a 15-year review. J Urol2000; 163: 265. Abstract, Google Scholar 15 : Bilateral Wilms' tumor—surgical aspects. Eur J Pediatr Surg2001; 11: 99. Google Scholar 16 : Nephron-sparing surgery for unilateral primary renal tumor in children. J Pediatr Surg2001; 36: 362. Google Scholar 17 : Partial nephrectomy in well-responding stage I Wilms' tumors: report of three cases. Pediatr Hematol Oncol1995; 12: 143. Google Scholar 18 : Bench surgery with autotransplantation for bilateral synchronous Wilms' tumor: a report of three cases. J Pediatr Surg1999; 34: 632. Google Scholar 19 : Surgery-related factors and local recurrence of Wilms tumor in National Wilms Tumor Study 4. Ann Surg1999; 229: 292. Google Scholar From the Department of Pediatric Surgery, University Children's Hospital Basel (F-MH, DvS), Basel, Switzerland, and Central Pediatric Tumor Registry, Department of Pathology, University of Kiel (DH), Kiel, Pediatric Surgery, DRK-Klinik Siegen (DB), Siegen and Pediatric Oncology, University Hospital Homburg/Saar (NG), Homburg/Saar, Germany© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byHubertus J, Günther B, Becker K, Graf N, Furtwängler R, Ferrari R, Gruhn B, Stahl R, von Schweinitz D and Stehr M (2014) Development of Hypertension is Less Frequent after Bilateral Nephron Sparing Surgery for Bilateral Wilms Tumor in a Long-Term SurveyJournal of Urology, VOL. 193, NO. 1, (262-267), Online publication date: 1-Jan-2015.Wang H, Abern M, Cost N, Chu D, Ross S, Wiener J and Routh J (2014) Use of Nephron Sparing Surgery and Impact on Survival in Children with Wilms Tumor: A SEER AnalysisJournal of Urology, VOL. 192, NO. 4, (1196-1202), Online publication date: 1-Oct-2014.Ferrer F, Rosen N, Herbst K, Fernandez C, Khanna G, Dome J, Mullen E, Gow K, Barnhart D, Shamberger R, Ritchey M and Ehrlich P (2013) Image Based Feasibility of Renal Sparing Surgery for Very Low Risk Unilateral Wilms Tumors: A Report from the Children's Oncology GroupJournal of Urology, VOL. 190, NO. 5, (1846-1851), Online publication date: 1-Nov-2013.Romão R, Pippi Salle J, Shuman C, Weksberg R, Figueroa V, Weber B, Bägli D, Farhat W, Grant R, Gerstle J and Lorenzo A (2012) Nephron Sparing Surgery for Unilateral Wilms Tumor in Children with Predisposing Syndromes: Single Center Experience Over 10 YearsJournal of Urology, VOL. 188, NO. 4S, (1493-1499), Online publication date: 1-Oct-2012.Cost N, Lubahn J, Granberg C, Sagalowsky A, Wickiser J, Gargollo P, Baker L, Margulis V and Rakheja D (2012) Pathological Review of Wilms Tumor Nephrectomy Specimens and Potential Implications for Nephron Sparing Surgery in Wilms TumorJournal of Urology, VOL. 188, NO. 4S, (1506-1510), Online publication date: 1-Oct-2012.Ritchey M (2011) Nephron Sparing Surgery for Wilms Tumor—Where is the Future?Journal of Urology, VOL. 186, NO. 4, (1179-1180), Online publication date: 1-Oct-2011.Lange J, Peterson S, Takashima J, Grigoriev Y, Ritchey M, Shamberger R, Beckwith J, Perlman E, Green D and Breslow N (2011) Risk Factors for End Stage Renal Disease in Non-WT1-Syndromic Wilms TumorJournal of Urology, VOL. 186, NO. 2, (378-386), Online publication date: 1-Aug-2011.Krupski T (2010) Malignancy and Augmentation—How Worried Should We Be?Journal of Urology, VOL. 184, NO. 6, (2231-2232), Online publication date: 1-Dec-2010.Ritchey M (2018) RENAL SPARING SURGERY FOR WILMS TUMORJournal of Urology, VOL. 174, NO. 4 Part 1, (1172-1173), Online publication date: 1-Oct-2005.ZANI A, SCHIAVETTI A, GAMBINO M, COZZI D, CONFORTI A and COZZI F (2018) LONG-TERM OUTCOME OF NEPHRON SPARING SURGERY AND SIMPLE NEPHRECTOMY FOR UNILATERAL LOCALIZED WILMS TUMORJournal of Urology, VOL. 173, NO. 3, (946-948), Online publication date: 1-Mar-2005. Volume 170Issue 3September 2003Page: 939-944 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordsnephroblastomakidney neoplasmsnephrectomyantineoplastic agentsMetrics Author Information FRANK-MARTIN HAECKER More articles by this author DIETRICH von SCHWEINITZ More articles by this author DIETER HARMS More articles by this author DIETRICH BUERGER More articles by this author NORBERT GRAF More articles by this author Expand All Advertisement PDF downloadLoading ...