Evaluation of the nephron-sparing surgery formula in Wilms tumors.
Wilms
children
formula
nephron-sparing surgery
Journal
Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
11
02
2020
revised:
16
07
2020
accepted:
30
07
2020
pubmed:
19
8
2020
medline:
26
1
2021
entrez:
19
8
2020
Statut:
ppublish
Résumé
Definitions of nephron-sparing surgery (NSS) procedures in Wilms tumor (WT) are not clear. The new UMBRELLA protocol offers a formula (NSS(X)-SRM(n)-PRM(n)-RRP(n%)) to better define the different NSS parameters. We aimed to assess the advantages and limits of this new formula. This retrospective monocentric study included patients operated by NSS for WT from 1975 to 2018. We reviewed the medical records and applied the NSS formula to all included patients. Eighty kidneys were operated on 56 patients at a mean age of 19.2 months (4 days-7.5 years), with 49 partial nephrectomies and 31 tumorectomies. The assessment of the surgical resection margins (SRM) showed a doubt in six cases and one tumor breach. An intact pseudocapsule along the resection margin with no renal parenchyma was found in four cases at pathological resection margins (PRM) assessment, whereas a tumor breach was described in seven cases. Among the six patients with a surgical doubt, only one had a pathological stage III. There were no surgical doubts in the seven patients with tumor breach at pathology. At a mean follow-up of eight years (15 days-28.6 years), eight patients had elevated blood pressure levels. Ten had proteinuria. These two parameters were significantly increased in patients with a remaining renal parenchyma (RRP) of less than half of the initial total renal parenchyma. The serum creatinine level was normal for all except two patients. The new NSS formula described all the crucial elements of NSS. RRP seemed essential for the evaluation of long-term renal function.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e28661Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
Lacour B, Guyot-Goubin A, Guissou S, Bellec S, Désandes E, Clavel J. Incidence of childhood cancer in France: national children cancer registries, 2000-2004. Eur J Cancer Prevention. 2010;19:173-181.
Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. Campbell-Walsh urology: expert consult premium edition: enhanced online features and print, 4-volume set. Philadelphia: Elsevier Health Sciences. 2011.
Blute ML, Kelalis PP, Offord KP, Breslow N, Beckwith JB, D'Angio GJ. Bilateral Wilms tumor. J Urol. 1987;138:968-973.
Coppes MJ, De Kraker J, Van Dijken PJ, et al. Bilateral Wilms' tumor: long-term survival and some epidemiological features. J Clin Oncol. 1989;7:310-315.
Breslow N, Olshan A, Beckwith JB, Green DM. Epidemiology of Wilms tumor. Med Ped Oncol. 1993;21:172-181.
Breslow NE, Beckwith JB. Epidemiological features of Wilms' tumor: results of the National Wilms' Tumor Study. J Natl Cancer Institute. 1982;68:429-436.
Rickham PP. Bilateral Wilms' tumour. Br J Surg. 1957;44:492-495.
Bishop HC, Tefft M, Evans AE, D'Angio GJ. Survival in bilateral Wilms' tumor-review of 30 National Wilms' Tumor Study cases. J Pediatr Surg. 1977;12:631-638.
Cooper CS, Jaffe WI, Huff DS, et al. SNYDER III HM. The role of renal salvage procedures for bilateral Wilms tumor: a 15-year review. J Urol. 2000;163:265-268.
Kubiak R, Gundeti M, Duffy PG, Ransley PG, Wilcox DT. Renal function and outcome following salvage surgery for bilateral Wilms’ tumor. J Pediatr Surg. 2004;39:1667-1672.
Cozzi DA, Zani A. Nephron-sparing surgery in children with primary renal tumor: indications and results. Semin Pediatr Surg. 2006;15:3-9.
Godzinski J, Graf N, Audry G. Current concepts in surgery for Wilms tumor-the risk and function-adapted strategy. Eur J Pediatr Surg. 2014;24:457-460.
Hubertus J, Günther B, Becker K, et al. Development of hypertension is less frequent after bilateral nephron sparing surgery for bilateral Wilms tumor in a long-term survey. J Urol. 2015;193:262-267.
Oue T, Koshinaga T, Okita H, Kaneko Y, Hinotsu S, Fukuzawa M. Bilateral Wilms tumors treated according to the Japan Wilms Tumor Study group protocol. Pediatr Blood Cancer. 2014;61:1184-1189.
Schwartz GJ, Munoz A, Schneider MF, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol. 2009;20:629-637.
Hogg RJ. National Kidney Foundation's Kidney Disease Outcomes Quality Initiative. National Kidney Foundation's Kidney Disease Outcomes Quality Initiative clinical practice guidelines for chronic kidney disease in children and adolescents: evaluation, classification, and stratification. Pediatrics. 2003;111:1416-1421.
Schwartz GJ, Furth S, Cole SR, Warady B, Munoz A. Glomerular filtration rate via plasma iohexol disappearance: pilot study for chronic kidney disease in children. Kidney Int. 2006;69:2070-2077.
Interiano RB, McCarville MB, Santos ND, et al. Comprehensive renal function evaluation in patients treated for synchronous bilateral Wilms tumor. J Pediatr Surg. 2017;52:98-103.
Charlton J, Irtan S, Bergeron C, Pritchard-Jones K. Bilateral Wilms tumour: a review of clinical and molecular features. Exp Rev Mol Med. 2017;19:e8.
Davidoff AM, Interiano RB, Wynn L, et al. Overall survival and renal function of patients with synchronous bilateral Wilms tumor undergoing surgery at a single institution. Ann Surg. 2015;262:570.
Ceccanti S, Cozzi F, Cervellone A, Zani A, Cozzi DA. Volume and function of the operated kidney after nephron-sparing surgery for unilateral renal tumor. J Pediatr Surg. 2019;54:326-330.