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106
29
th
CONGRESS OF THE ESPU
S13: ONCOLOGY
Moderators: Yves Heloury (Australia), Sergei Zorkin (Russia)
ESPU Meeting on Friday 13, April 2018, 08:00–08:52
08:00–08:03
S13-1 (PP)
★
NEPHRON SPARING SURGERY VERSUS SIMPLE
NEPHRECTOMY FOR UNILATERAL LOCALIZED WILMS
TUMOR
Shankar K, R.B. NERLI, Shridhar GHAGANE and Neeraj DIXIT
Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & MRC, Belagavi, Ind, Department
of Urology, Belagavi, INDIA
PURPOSE
Traditionally children with Wilms tumor (WT) were managed with radical nephrectomy. More
recently NSS has been reported for children with WT in the absence of absolute indications. In
this present study we have prospectively assessed survival and local recurrence rates in children
with unilateral localized Wilms tumor (WT) treated with either nephron sparing surgery (NSS) or
simple nephrectomy with removal only of the perirenal fat adherent to the tumor surface. In this
present study we have prospectively assessed survival and local recurrence rates in children with
unilateral localized Wilms tumor (WT) treated with either nephron sparing surgery (NSS) or simple
nephrectomy with removal only of the perirenal fat adherent to the tumor surface.
MATERIAL AND METHODS
Children presenting with unilateral Wilms tumor during the period Jan 2006 to Dec 2015 were
prospectively randomized to undergo either simple nephrectomy along with removal of perirenal
adherent fat or nephron sparing surgery. Treatment was administered to children according to the
SIOP protocol 2001.
RESULTS
During the study period 28 children with Wilms tumor were operated. Thirteen children underwent
simple nephrectomy, whereas the remaining 15 underwent nephron sparing surgery. The opposite
kidneys were normal on USG and CT. The mean age at intervention was 44 months. Eight children
had stage I disease and the remaining had stage II disease. No intraoperative complications were
noted. The follow-up ranged 24–136 months and all children are alive. Only one child had lo-
cal recurrence and underwent radiotherapy and chemotherapy. The was no difference in overall
survival in both the groups. The post-operative GFR was significantly higher in children undergoing
NSS, though the serum creatinine was within normal range in all children. The eventful survival was
96.42 %.
CONCLUSIONS
The oncological outcome of NSS for unilateral Wilms tumor is as good as simple nephrectomy with
better preservation of renal function.