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J Pediatr Surg. 2014 Nov;49(11):1544-8. doi: 10.1016/j.jpedsurg.2014.06.005. Epub 2014 Oct 1.

Minimally invasive nephrectomy for Wilms tumors in children - data from SIOP 2001.

Author information

1
Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Germany. Electronic address: steven.warmann@med.uni-tuebingen.de.
2
Department of Pediatric Surgery, Marciniak Hospital, Wroclaw and Chair of Emergency Medicine, Medical University, Wroclaw, Poland.
3
Comprehensive Cancer Centre, Amsterdam, The Netherlands.
4
Pediatric Surgical Center of Amsterdam (ECH-AMC/VUmc), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
5
Department of Paediatric Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
6
Childhood Cancer Research Unit, Astrid Lindgren's Children's Hospital, Karolinska Institutet, Stockholm, Sweden.
7
Department of Pediatric Hematology and Oncology, University Hospital Homburg/Saar, Germany.
8
Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Germany.

Abstract

PURPOSE:

To analyse the surgical and oncological outcome of minimally invasive surgery (MIS) for tumor nephrectomy in Wilms tumor (WT) patients.

METHODS:

WT patients from the SIOP 2001 trial, undergoing MIS for tumor nephrectomy were analyzed with regard to demographic characterization, surgical specifications, complications, and outcome.

RESULTS:

There were 24 children matching the inclusion criteria. Median age at operation was 40.35 months (14.3-65.4). All patients received preoperative chemotherapy. Median tumor volume was 177.5 ml at diagnosis (46.5-958) and 73.0 ml at surgery (3.8-776). There was one surgical complication (splenic injury), no intraoperative tumor rupture occurred. Abdominal stage was I in 14, II in 7, and III in 3 patients. Adequate lymph node sampling was performed in only 2 patients. One local relapse occurred. Event-free survival was 23/24, overall survival was 24/24, median follow up was 47 months (2-114).

CONCLUSIONS:

We present the largest series so far of minimally invasive nephrectomies for nephroblastoma based on a multinational trial. Treatment results were comparable to those of open surgery; however, experience of operating surgeons was generally high. Discipline of lymph node sampling was inadequate. Based on this analysis a prospective study on MIS in nephroblastoma is planned by the SIOP Renal Tumor Study Group.

KEYWORDS:

Laparoscopy; Nephroblastoma; Tumor resection

PMID:
25475791
DOI:
10.1016/j.jpedsurg.2014.06.005
[Indexed for MEDLINE]

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