Laparoscopic Treatment of Wilms' Tumor: Criteria of SIOP-UMBRELLA Protocol may be Updated.
Child
Laparoscopy
Nephroblastoma
Radical nephrectomy
SIOP-UMBRELLA protocol
Wilms’ tumor
Journal
Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840
Informations de publication
Date de publication:
02 Sep 2024
02 Sep 2024
Historique:
received:
31
08
2023
accepted:
04
08
2024
medline:
2
9
2024
pubmed:
2
9
2024
entrez:
2
9
2024
Statut:
aheadofprint
Résumé
Total nephrectomies for the treatment of Wilms' tumor (WT) are more and more performed by laparoscopy, although indications for this approach following the UMBRELLA guidelines are currently very restrictive. The purpose of this study was to assess the compliance to the criteria of the UMBRELLA protocol for minimally invasive approach of WT. This retrospective multicenter study included children operated on by laparoscopic total nephrectomy for suspected WT before 2020. Imaging was reviewed centrally. Fifty-six patients (50 WT and 6 nephrogenic rests) were operated on at a median age of 3.3 ± 2.6 years. Thirteen (23%) patients had metastasis at diagnosis. The mean operative time was 213 ± 84 min. There were eight (14.3%) conversions and five peroperative complications. A local stage III was confirmed in seven (12.5%) cases, including two for tumor rupture. Only one (1.8%) of the procedures followed the SIOP-UMBRELLA indications for laparoscopy. The criterion "ring of normal parenchyma" was met only once. Conservative surgery seemed possible in ten (17.9%) cases. The extension of the tumor beyond the ipsilateral edge of the vertebra after chemotherapy and a volume over 200 mL were associated with an increased risk of conversion (p = 0.0004 and p = 0.001 respectively). After a mean follow-up of 5.2 ± 4.0 years, although there was no local recurrence, one death occurred due to metastatic progression at 15 months postoperatively. The laparoscopic approach of WT beyond the UMBRELLA recommendations was feasible with low risk of local recurrence. Its indications may be updated and validated.
Identifiants
pubmed: 39222300
doi: 10.1245/s10434-024-16057-3
pii: 10.1245/s10434-024-16057-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. Society of Surgical Oncology.
Références
Duarte RJ, Dénes FT, Cristofani LM, Odone-Filho V, Srougi M. Further experience with laparoscopic nephrectomy for Wilms’ tumour after chemotherapy. BJU Int. 2006;98(1):155–9. https://doi.org/10.1111/j.1464-410X.2006.06214.x .
doi: 10.1111/j.1464-410X.2006.06214.x
pubmed: 16831161
Varlet F, Stephan JL, Guye E, Allary R, Berger C, Lopez M. Laparoscopic radical nephrectomy for unilateral renal cancer in children. Surg Laparosc Endosc Percutan Tech. 2009;19(2):148–52. https://doi.org/10.1097/SLE.0b013e31819f204d .
doi: 10.1097/SLE.0b013e31819f204d
pubmed: 19390283
Duarte RJ, Dénes FT, Cristofani LM, Giron AM, Filho VO, Arap S. Laparoscopic nephrectomy for wilms tumor after chemotherapy: initial experience. J Urol. 2004;172(4 Pt 1):1438–40. https://doi.org/10.1097/01.ju.0000138230.51134.65 .
doi: 10.1097/01.ju.0000138230.51134.65
pubmed: 15371863
van den Heuvel-Eibrink MM, Hol JA, Pritchard-Jones K, et al. Position paper: rationale for the treatment of Wilms tumour in the UMBRELLA SIOP-RTSG 2016 protocol. Nat Rev Urol. 2017;14(12):743–52. https://doi.org/10.1038/nrurol.2017.163 .
doi: 10.1038/nrurol.2017.163
pubmed: 29089605
Varlet F, Petit T, Leclair MD, et al. Laparoscopic treatment of renal cancer in children: a multicentric study and review of oncologic and surgical complications. J Pediatr Urol. 2014;10(3):500–5. https://doi.org/10.1016/j.jpurol.2013.11.005 .
doi: 10.1016/j.jpurol.2013.11.005
pubmed: 24332932
Duarte RJ, Cristofani LM, Filho VO, Srougi M, Dénes FT. Videolaparoscopic radical nephrectomy after chemotherapy in the treatment of Wilms’ tumor: Long-term results of a pioneer group. J Pediatr Urol. 2017;13(1):50.e1-50.e5. https://doi.org/10.1016/j.jpurol.2016.09.004 .
doi: 10.1016/j.jpurol.2016.09.004
pubmed: 28288778
Bouty A, Burnand K, Nightingale M, et al. What is the risk of local recurrence after laparoscopic transperitoneal radical nephrectomy in children with Wilms tumours? Analysis of a local series and review of the literature. J Pediatr Urol. 2018;14(4):327.e1-327.e7. https://doi.org/10.1016/j.jpurol.2018.03.016 .
doi: 10.1016/j.jpurol.2018.03.016
pubmed: 29705138
Burnand K, Roberts A, Bouty A, Nightingale M, Campbell M, Heloury Y. Laparoscopic nephrectomy for Wilms’ tumor: can we expand on the current SIOP criteria? J Pediatr Urol. 2018;14(3):253.e1-253.e8. https://doi.org/10.1016/j.jpurol.2018.01.005 .
doi: 10.1016/j.jpurol.2018.01.005
pubmed: 29501377
Bouty A, Blanc T, Leclair MD, et al. Minimally invasive surgery for unilateral Wilms tumors: multicenter retrospective analysis of 50 transperitoneal laparoscopic total nephrectomies. Pediatr Blood Cancer. 2020;67(5):e28212. https://doi.org/10.1002/pbc.28212 .
doi: 10.1002/pbc.28212
pubmed: 32064752
Fuchs J, Kienecker K, Furtwängler R, et al. Surgical aspects in the treatment of patients with unilateral wilms tumor: a report from the SIOP 93–01/German society of pediatric oncology and hematology. Ann Surg. 2009;249(4):666–71. https://doi.org/10.1097/SLA.0b013e31819ed92b .
doi: 10.1097/SLA.0b013e31819ed92b
pubmed: 19300220
Spreafico F, Fernandez CV, Brok J, et al. Wilms tumour. Nat Rev Dis Primers. 2021;7(1):75. https://doi.org/10.1038/s41572-021-00308-8 .
doi: 10.1038/s41572-021-00308-8
pubmed: 34650095
Taghavi K, Sarnacki S, Blanc T, Boyer O, Heloury Y. The rationale for nephron-sparing surgery in unilateral non-syndromic Wilms tumour. Pediatr Nephrol. 2024;39(4):1023–32. https://doi.org/10.1007/s00467-023-06099-2 .
doi: 10.1007/s00467-023-06099-2
pubmed: 37603086
Breslow NE, Collins AJ, Ritchey ML, Grigoriev YA, Peterson SM, Green DM. End stage renal disease in patients with Wilms tumor: results from the National Wilms Tumor study group and the United States renal data system. J Urol. 2005;174(5):1972–5. https://doi.org/10.1097/01.ju.0000176800.00994.3a .
doi: 10.1097/01.ju.0000176800.00994.3a
pubmed: 16217371
pmcid: 1483840
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(1):262–6. https://doi.org/10.1016/j.juro.2014.07.116 .
doi: 10.1016/j.juro.2014.07.116
pubmed: 25108274
Raval MV, Bilimoria KY, Bentrem DJ, et al. Nodal evaluation in Wilms’ tumors: analysis of the national cancer data base. Ann Surg. 2010;251(3):559–65. https://doi.org/10.1097/SLA.0b013e3181cc95d7 .
doi: 10.1097/SLA.0b013e3181cc95d7
pubmed: 20083995
Kieran K, Anderson JR, Dome JS, et al. Lymph node involvement in Wilms tumor: results from national wilms tumor studies 4 and 5. J Pediatr Surg. 2012;47(4):700–6. https://doi.org/10.1016/j.jpedsurg.2011.08.017 .
doi: 10.1016/j.jpedsurg.2011.08.017
pubmed: 22498384
pmcid: 3976547
Saltzman AF, Smith DE, Gao D, et al. How many lymph nodes are enough? Assessing the adequacy of lymph node yield for staging in favorable histology wilms tumor. J Pediatr Surg. 2019;54(11):2331–5. https://doi.org/10.1016/j.jpedsurg.2019.06.010 .
doi: 10.1016/j.jpedsurg.2019.06.010
pubmed: 31255328
pmcid: 6881092
Romao RLP, Weber B, Gerstle JT, et al. Comparison between laparoscopic and open radical nephrectomy for the treatment of primary renal tumors in children: single-center experience over a 5-year period. J Pediatr Urol. 2014;10(3):488–94. https://doi.org/10.1016/j.jpurol.2013.11.002 .
doi: 10.1016/j.jpurol.2013.11.002
pubmed: 24331167
Warmann SW, Godzinski J, van Tinteren H, et al. Minimally invasive nephrectomy for Wilms tumors in children—data from SIOP 2001. J Pediatr Surg. 2014;49(11):1544–8. https://doi.org/10.1016/j.jpedsurg.2014.06.005 .
doi: 10.1016/j.jpedsurg.2014.06.005
pubmed: 25475791
Denning NL, Kallis MP, Prince JM. Pediatric robotic surgery. Surg Clin North Am. 2020;100(2):431–3. https://doi.org/10.1016/j.suc.2019.12.004 .
doi: 10.1016/j.suc.2019.12.004
pubmed: 32169188
Blanc T, Meignan P, Vinit N, et al. Robotic surgery in pediatric oncology: lessons learned from the first 100 tumors-a nationwide experience. Ann Surg Oncol. 2022;29(2):1315–26. https://doi.org/10.1245/s10434-021-10777-6 .
doi: 10.1245/s10434-021-10777-6
pubmed: 34523002
Ezekian B, Englum BR, Gulack BC, et al. Comparing oncologic outcomes after minimally invasive and open surgery for pediatric neuroblastoma and Wilms tumor. Pediatr Blood Cancer. 2018. https://doi.org/10.1002/pbc.26755 .
doi: 10.1002/pbc.26755
pubmed: 28792662