Minimally invasive nephrectomy for Wilms tumors in children - data from SIOP 2001.

Abstract

PURPOSE:

To analyse the surgical and oncological outcome of minimally invasive surgery (MIS) for tumor nephrectomy in Wilms tumor (WT) patients.

METHODS:

WT patients from the SIOP 2001 trial, undergoing MIS for tumor nephrectomy were analyzed with regard to demographic characterization, surgical specifications, complications, and outcome.

RESULTS:

There were 24 children matching the inclusion criteria. Median age at operation was 40.35 months (14.3-65.4). All patients received preoperative chemotherapy. Median tumor volume was 177.5 ml at diagnosis (46.5-958) and 73.0 ml at surgery (3.8-776). There was one surgical complication (splenic injury), no intraoperative tumor rupture occurred. Abdominal stage was I in 14, II in 7, and III in 3 patients. Adequate lymph node sampling was performed in only 2 patients. One local relapse occurred. Event-free survival was 23/24, overall survival was 24/24, median follow up was 47 months (2-114).

CONCLUSIONS:

We present the largest series so far of minimally invasive nephrectomies for nephroblastoma based on a multinational trial. Treatment results were comparable to those of open surgery; however, experience of operating surgeons was generally high. Discipline of lymph node sampling was inadequate. Based on this analysis a prospective study on MIS in nephroblastoma is planned by the SIOP Renal Tumor Study Group.

• Authors: Steven W Warmann, Jan Godzinski, Harm van Tinteren, Hugo Heij, Mark Powis, Bengt Sandstedt, Norbert Graf, Jörg Fuchs, Surgical Panel of the SIOP Renal Tumor Strategy Group
• Journal: Journal of pediatric surgery (J Pediatr Surg) Vol. 49 Issue 11 Pg. 1544-8 (Nov 2014) ISSN: 1531-5037 [Electronic] United States
• PMID: 25475791 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Topics

• Child
• Child, Preschool
• Disease-Free Survival
• Female
• Humans
• Infant
• Kidney Neoplasms (pathology, surgery)
• Male
• Minimally Invasive Surgical Procedures
• Neoplasm Recurrence, Local (surgery)
• Neoplasm Staging
• Nephrectomy (methods)
• Netherlands
• Prognosis
• Prospective Studies
• Registries
• Treatment Outcome
• Wilms Tumor (surgery)