EN
TÜRKÇE
Poster - 282
A single-center study on nephron sparing surgery for unilateral Wilm's tumor
Dongfang Lu
Children's Hospital Zhejiang University of Medicine
Objective: To explore the indications, safety, and value of nephron sparing surgery (NSS) in the treatment of unilateral Wilm's tumor (UWT).
Method: Children's Hospital Zhejiang University School of Medicine started the study on the feasibility of the application of NSS in UWT in January 2020. The inclusion criteria for NSS surgery are: 1) unilateral Wilm's tumor; 2) If there is biopsy pathology, the pathological type is favorable histopathological(FH); 3) Unipolar lesion; 4) There is a boundary between tumors and normal renal parenchyma; 5) There is no tumor surrounding the renal portal vessels and no tumor thrombus in the renal veins; 6) The tumor did not break through the renal capsule. From January 2020 to September 2023, a total of 10 pediatric patients were enrolled, and their demographic characteristics, imaging and pathological features, perioperative complications, renal function changes, and treatment prognosis were statistically analyzed.
Result：The majority of enrolled children in this study were female (8/10), with a median age of initial diagnosis of 33.5 months (10 months to 76 months). According to NWTS-5 staging, all patients were in stages I-III(stage III patients were all increased due to biopsy staging), and most of them had a single lesion. All postoperative pathological changes in the patients were non anaplastic and had negative margins. No serious complications such as urinary leakage or loss of vital organs were found after surgery; Some patients may have abnormal urine routine or mild renal function after surgery, but they gradually recover to the normal range during follow-up. One patient was found to have lung metastases during postoperative follow-up, and was treated with enhanced chemotherapy followed by surgical resection of the metastases and concurrent radiotherapy. Currently, he’s in a state of complete relief. There is no residual or recurrent of the tumor in the surgical area or distant metastasis was found in the remaining patients. As of the last follow-up (from 1 to 42 months), all patients survived well.
Conclusion: The application of NSS is safe and feasible in children with unilateral Wilm's tumor who meet specific conditions.