BACKGROUND: The treatment of bilateral Wilms tumors (WT) requires multimodality therapy with individualized decision to ensure cure while preserving as much renal parenchyma as possible. PROCEDURE: We analyzed the clinical records of 49 children with bilateral WT treated in France between 1993 and 2001, according to the SIOP-93 guidelines (individual treatment program: Treatment was continued as long as there was imaging evidence of tumor regression). Pathology reports, duration of preoperative chemotherapy and surgical records were also reviewed. Overall Survival (OS) and Event-Free Survival (EFS) rates were studied and relationships between possible prognostic factors and survival were assessed. RESULTS: Imaging studies revealed bilateral involvement in 98% of the cases. Whatever the response to preoperative chemotherapy, the mean duration of neoadjuvant chemotherapy was 80 days (Q1-Q3: 47-89 days). Forty-eight children underwent nephron sparing surgery (NSS) at least for one kidney and 19 for both. Five-year EFS and OS rates were, respectively, 83.4 and 89.5%. Only the most advanced stages were shown to affect OS (P = 0.03). At study endpoint, end-stage renal disease (ESRD) was reported in seven children, associated with a predisposing phenotype in three. CONCLUSIONS: Results of this study demonstrate a favorable outcome of patients with bilateral WT receiving an individual treatment program. With a tailored approach to treatment according to the tumor response, 77% of our patients were operated before the third month of preoperative chemotherapy. In spite of good survival, 14% of our patients have ESRD.
BACKGROUND: The treatment of bilateral Wilms tumors (WT) requires multimodality therapy with individualized decision to ensure cure while preserving as much renal parenchyma as possible. PROCEDURE: We analyzed the clinical records of 49 children with bilateral WT treated in France between 1993 and 2001, according to the SIOP-93 guidelines (individual treatment program: Treatment was continued as long as there was imaging evidence of tumor regression). Pathology reports, duration of preoperative chemotherapy and surgical records were also reviewed. Overall Survival (OS) and Event-Free Survival (EFS) rates were studied and relationships between possible prognostic factors and survival were assessed. RESULTS: Imaging studies revealed bilateral involvement in 98% of the cases. Whatever the response to preoperative chemotherapy, the mean duration of neoadjuvant chemotherapy was 80 days (Q1-Q3: 47-89 days). Forty-eight children underwent nephron sparing surgery (NSS) at least for one kidney and 19 for both. Five-year EFS and OS rates were, respectively, 83.4 and 89.5%. Only the most advanced stages were shown to affect OS (P = 0.03). At study endpoint, end-stage renal disease (ESRD) was reported in seven children, associated with a predisposing phenotype in three. CONCLUSIONS: Results of this study demonstrate a favorable outcome of patients with bilateral WT receiving an individual treatment program. With a tailored approach to treatment according to the tumor response, 77% of our patients were operated before the third month of preoperative chemotherapy. In spite of good survival, 14% of our patients have ESRD.
Authors: Marry M van den Heuvel-Eibrink; Janna A Hol; Kathy Pritchard-Jones; Harm van Tinteren; Rhoikos Furtwängler; Arnauld C Verschuur; Gordan M Vujanic; Ivo Leuschner; Jesper Brok; Christian Rübe; Anne M Smets; Geert O Janssens; Jan Godzinski; Gema L Ramírez-Villar; Beatriz de Camargo; Heidi Segers; Paola Collini; Manfred Gessler; Christophe Bergeron; Filippo Spreafico; Norbert Graf Journal: Nat Rev Urol Date: 2017-10-31 Impact factor: 14.432
Authors: Peter Ehrlich; Yuen Y Chi; Murali M Chintagumpala; Fred A Hoffer; Elizabeth J Perlman; John A Kalapurakal; Ann Warwick; Robert C Shamberger; Geetika Khanna; Tom E Hamilton; Ken W Gow; Arnold C Paulino; Eric J Gratias; Elizabeth A Mullen; James I Geller; Paul E Grundy; Conrad V Fernandez; Michael L Ritchey; James S Dome Journal: Ann Surg Date: 2017-09 Impact factor: 12.969
Authors: Murali M Chintagumpala; Elizabeth J Perlman; Brett Tornwall; Yueh-Yun Chi; Yeonil Kim; Fredric A Hoffer; John A Kalapurakal; Anne B Warwick; Robert C Shamberger; Geetika Khanna; Thomas E Hamilton; Kenneth W Gow; Arnold C Paulino; Eric J Gratias; Elizabeth A Mullen; James I Geller; Conrad V Fernandez; Michael L Ritchey; Paul E Grundy; Jeffrey S Dome; Peter F Ehrlich Journal: Cancer Date: 2022-04-05 Impact factor: 6.921
Authors: Andrew M Davidoff; Rodrigo B Interiano; Lynn Wynn; Noel Delos Santos; Jeffrey S Dome; Daniel M Green; Rachel C Brennan; M Beth McCarville; Matthew J Krasin; Kathleen Kieran; Mark A Williams Journal: Ann Surg Date: 2015-10 Impact factor: 12.969
Authors: Esmee Cm Kooijmans; Arend Bökenkamp; Nic S Tjahjadi; Jesse M Tettero; Eline van Dulmen-den Broeder; Helena Jh van der Pal; Margreet A Veening Journal: Cochrane Database Syst Rev Date: 2019-03-11