Oncology: The Role of Partial Nephrectomy in Wilms Tumor

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• 作者：Miriam Harel (1) (2) (3)
  John H. Makari (1) (2) (3)
  Fernando A. Ferrer Jr. (1) (2) (3)
  
• 关键词：Wilms tumor ; Partial nephrectomy ; Nephron sparing surgery ; Renal function
• 刊名：Current Urology Reports
• 出版年：2013
• 出版时间：August 2013
• 年：2013
• 卷：14
• 期：4
• 页码：350-358
• 全文大小：204KB
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• 作者单位：Miriam Harel (1) (2) (3)
  John H. Makari (1) (2) (3)
  Fernando A. Ferrer Jr. (1) (2) (3)
  
  1. Connecticut Children鈥檚 Medical Center, Hartford, CT, USA
  2. University of Connecticut School of Medicine, Farmington, CT, USA
  3. Division of Urology, Connecticut Children鈥檚 Medical Center, 282 Washington Street, Suite 2E, Hartford, CT, 06106, USA
  

文摘

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.