Next Article in Journal
Evaluation of a Walking-Track Intervention to Increase Children’s Physical Activity during Primary School Break Times
Next Article in Special Issue
Pediatric Solid Tumors in Resource-Constrained Settings: A Review of Available Evidence on Management, Outcomes, and Barriers to Care
Previous Article in Journal
Developmental Support for Sick Children through Play in Japan’s ECEC System: A Comparison with Hospital Play Specialists
Article Menu
Issue 10 (October) cover image

Export Article

Open AccessReview
Children 2018, 5(10), 134; https://doi.org/10.3390/children5100134

Bilateral Wilms Tumor: A Surgical Perspective

1
Department of Surgery, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
2
Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN 38105, USA
*
Author to whom correspondence should be addressed.
Received: 17 August 2018 / Revised: 13 September 2018 / Accepted: 21 September 2018 / Published: 24 September 2018
(This article belongs to the Special Issue Pediatric Surgical Oncology)
  |  
PDF [1378 KB, uploaded 24 September 2018]
  |  

Abstract

Historically, the management of bilateral Wilms tumor (BWT) was non-standardized and suffered from instances of prolonged chemotherapy and inconsistent surgical management which resulted in suboptimal renal and oncologic outcomes. Because of the risk of end-stage renal disease associated with the management of BWT, neoadjuvant chemotherapy and nephron-sparing surgery have been adopted as the guiding management principles. This management strategy balances acceptable oncologic outcomes against the risk of end-stage renal disease. A recent multi-institutional Children’s Oncology Group study (AREN0534) has confirmed the benefits of standardized 3-drug neoadjuvant chemotherapy and the utilization of nephron-sparing surgery in BWT patients; however, less than 50% of patients underwent bilateral nephron-sparing surgery. The coordination of neoadjuvant chemotherapy and the timing and implementation of bilateral nephron-sparing surgery are features of BWT management that require collaboration between oncologists and surgeons. This review discusses the surgical management strategy in the context of BWT disease biology, with an emphasis on timepoints during therapy at which surgical decision making can greatly impact this disease and minimize long-term toxicities. View Full-Text
Keywords: bilateral Wilms tumor; nephron-sparing surgery bilateral Wilms tumor; nephron-sparing surgery
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Murphy, A.J.; Davidoff, A.M. Bilateral Wilms Tumor: A Surgical Perspective. Children 2018, 5, 134.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Children EISSN 2227-9067 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top