Is Pre-operative Chemotherapy Desirable in all Patients of Wilms’ Tumor?
- 98 Downloads
The timing and role of chemotherapy in the management of Wilms’ tumor has long been the matter of debate, with different groups showing equally comparable and encouraging results. Over the last decade, however, both the ideol-ogies seem to be converging and the attempt has been to identify groups benefitting with pre-operative chemotherapy, as well as those, where upfront resection should be attempted. In this article authors intend to discuss pros and cons of both the strategies and their applicability in a resource poor setting in developing countries like India.
KeywordsWilms’ tumor Pre-operative chemotherapy Upfront resection
AJ: Review of literature and drafting the manuscript; SA: Review of literature, prepared the final draft of the manuscript and will act as guarantor for the paper; SB: Review of the paper and medical oncology inputs.
Compliance with Ethical Standards
Conflict of Interest
Source of Funding
- 2.Gross RE. The surgery of infancy and childhood. Philadelphia: W.B. Saunders Co; 1953. p. 1000.Google Scholar
- 4.Tournade MF, Com-Nougué C, De Kraker J, et al. Optimal duration of pre-operative therapy in unilateral and non-metastatic Wilms tumour in children older than 6 months: results of the ninth International Society of Paediatric Oncology Wilms Tumour Trial and Study. J Clin Oncol. 2001;19:488–500.CrossRefPubMedGoogle Scholar
- 5.D’Angio GJ, Evans AE, Breslow N, et al. The treatment of Wilms’ tumor: results of the National Wilms’ Tumor Study. Cancer. 1976;38:633–46.Google Scholar
- 6.D’Angio GJ, Evans A, Breslow N, et al. The treatment of Wilms’ tumor: results of the second National Wilms’ Tumor Study. Cancer. 1981;47:2302–11.Google Scholar
- 7.D’Angio GJ, Breslow N, Beckwith JB, et al. Treatment of Wilms’ tumor. Results of the third National Wilms’ Tumor Study. Cancer. 1989;64:349–60.Google Scholar
- 9.Grundy PE, Breslow NE, Li S, et al; National Wilms Tumor Study Group. Loss of heterozygosity for chromosomes 1p and 16q is an adverse prognostic factor in favorable-histology Wilms tumor: a report from the National Wilms Tumor Study Group. J Clin Oncol. 2005;23:7312–21.Google Scholar
- 10.Lemerle J, Voute PA, Tournade MF, et al. Preoperative versus postoperative radiotherapy, single versus multiple courses of Actinomycin D in the treatment of Wilms’ tumor. Preliminary results of a controlled clinical trial conducted by the International Society of Paediatric Oncology (SIOP). Cancer. 1976;38:647–54.CrossRefPubMedGoogle Scholar
- 11.De Kraker J, Graf N, Pritchard-Jones K, et al. Nephroblastoma clinical trial and study SIOP 2001, Protocol. SIOP RTSG. 2001.Google Scholar
- 20.van den Heuvel-Eibrink MM, Grundy P, Graf N, et al. Characteristics and survival of 750 children diagnosed with a renal tumor in the first seven months of life: a collaborative study by the SIOP/GPOH/SFOP, NWTSG, and UKCCSG Wilms tumor study groups. Pediatr Blood Cancer. 2008;50:1130–4.CrossRefPubMedGoogle Scholar
- 24.Agarwala S, Bakhshi S, Srinivas M, et al. 41st Annual Conference of International Society of Paediatric Oncology SIOP 2009, Sao Paulo, Brazil, October 5–9, 2009. Wilms tumor: management strategies and outcomes of AIIMS-WRT-99 Trial. Pediatr Blood Cancer. 2009;53:712.Google Scholar
- 25.Koodiyedath B, Kulkarni KP, Arora RS. Outcomes of Wilms tumour in India: findings from a systematic analysis: PH039. Pediatr Blood Cancer. 2012;59:1061.Google Scholar
- 27.Moorthy G, Agarwala S, Bakhshi S, et al. Long term outcome of children with wilms tumor having intravascular thrombus. J Indian Assoc Pediatr Surg. 2009;14:152.Google Scholar
- 32.Prasad M, Vora T, Agarwala S, et al. Management of Wilms tumor: ICMR consensus document. Indian J Pediatr. 2017; doi: 10.1007/s12098-017-2305-5.
- 33.Agarwala S, Bajpai M, Bhatnagar V, et al. Effect of tumor spill on recurrence rate and outcome in patients with wilms tumor: results of AIIMS-WT 99 study. J Indian Assoc Pediatr Surg. 2009;14:151.Google Scholar
- 34.Godzinski J, Tournade MF, de Kraker J, et al. Rarity of surgical complications after post chemotherapy nephrectomy for nephroblastoma. Experience of the International Society of Paediatric Oncology — trial and study “SIOP-9”. International Society of Paediatric Oncology Nephroblastoma Trial and Study Committee. Eur J Pediatr Surg. 1998;8:83–6.CrossRefPubMedGoogle Scholar