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Oncology: The Role of Partial Nephrectomy in Wilms Tumor

  • Pediatric Urology (M Castellan and R Gosalbez, Section Editors)
  • Published:
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Abstract

Wilms tumor represents the most common pediatric renal malignancy and the fourth most common childhood cancer overall. Overall survival from Wilms tumor has increased to over 90 % secondary to multidisciplinary therapy and multi-institutional cooperative group trials. Recent therapeutic focus has shifted to reduction in treatment morbidity and renal preservation while maintaining the high survival rates. Partial nephrectomy is an integral component of the multimodal treatment protocols for Wilms tumor patients with bilateral disease, solitary kidney, or predisposing syndromes. Recent consideration has been given to utilization of nephron sparing surgery (NSS) in carefully selected patients with nonsyndromic unilateral Wilms tumor. While long-term, prospective data in this subgroup of patients is not yet available, case series demonstrate comparable oncologic outcomes after partial versus radical nephrectomy. The relative rarity of Wilms tumor, especially those amenable to upfront partial nephrectomy, presents a challenge to conducting controlled trials.

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Abbreviations

NWTS:

National Wilms Tumor Study Group

COG:

Children’s Oncology Group

SIOP:

International Society of Pediatric Oncology

NSS:

Nephron sparing surgery

ESRD:

End-stage renal disease

RCC:

Renal cell carcinoma

CKD:

Chronic kidney disease

GFR:

Glomerular filtration rate

CT:

Computerized tomography

MRI:

Magnetic resonance imaging

RFS:

Recurrence-free survival

OS:

Overall survival

PN:

Partial nephrectomy

RN:

Radical nephrectomy

UPJ:

Ureteropelvic junction

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Conflict of Interest

Dr. Miriam Harel reported no potential conflicts of interest relevant to this article.

Dr. John H. Makari reported no potential conflicts of interest relevant to this article.

Dr. Fernando A. Ferrer Jr. reported receiving a grant from NIH/NCI and multiple honoraria.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Connecticut Children’s Medical Center, Hartford, CT, USA

    Miriam Harel, John H. Makari & Fernando A. Ferrer Jr.

  2. University of Connecticut School of Medicine, Farmington, CT, USA

    Miriam Harel, John H. Makari & Fernando A. Ferrer Jr.

  3. Division of Urology, Connecticut Children’s Medical Center, 282 Washington Street, Suite 2E, Hartford, CT, 06106, USA

    Miriam Harel, John H. Makari & Fernando A. Ferrer Jr.

Authors
  1. Miriam Harel
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  2. John H. Makari
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  3. Fernando A. Ferrer Jr.
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Correspondence to Miriam Harel.

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Harel, M., Makari, J.H. & Ferrer, F.A. Oncology: The Role of Partial Nephrectomy in Wilms Tumor. Curr Urol Rep 14, 350–358 (2013). https://doi.org/10.1007/s11934-013-0330-0

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  • DOI: https://doi.org/10.1007/s11934-013-0330-0

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