Qu Yanchao,Zhang Weiping,Sun Ning,et al.Treatment of recurrent bilateral Wilms tumor in children: a report of 10 cases[J].Journal of Clinical Pediatric Surgery,,21():1123-1127.[doi:10.3760/cma.j.cn101785-202107017-005]
Treatment of recurrent bilateral Wilms tumor in children: a report of 10 cases
- Keywords:
- Wilms Tumor; Urologic Surgical Procedures; Recurrence; Reoperation; Child
- Abstract:
- Objective To summarize the clinical characteristics and treatment experiences of recurrent bilateral Wilms tumor and improve its overall treatment level.Methods From January 2008 to December 2020,retrospective review was performed for clinical data of 10 children hospitalized with bilateral recurrent Wilms tumor.Initial operation,recurrent time/site,treatment options and follow-ups were recorded.Results There were 7 boys and 3 girls with an average age of 27.3(10-69)month.A total of 18 tumors underwent nephron-sparing surgery.One child underwent nephrectomy since tumor was located in hilum and preserving kidney proved difficult.Two cases were not operated due to multiple small tumors.Postoperative pathology revealed a favorable prognosis and there was no anaplasia Postoperative recurrence time was(2-36)months.In one case,bilateral recurrence occurred immediately with retroperitoneal lymph node metastasis.Surgery was not re-performed and chemotherapy predominated.Death occurred after mediastinal metastasis.All the other 9 cases were detected initially in unilateral kidney.In one case,tumor disappeared after 9-month chemotherapy alone.Nephron-sparing surgery(NSS)was performed in 8 children.Recurrence was absent(n=5)and secondary(n=3).One child had postoperative in situ recurrence with pulmonary metastasis.And tumor nephrectomy and wedge resection of pulmonary lobe were performed.Another two cases died from multiple metastases.Postoperative chemotherapeutic agents included vincristine,doxorubicin,cyclophosphamide,etoposide and carboplatin.However,regimen was not completely unified.Postoperative radiotherapy was offered for only 1 child.During a follow-up period of(19-108)months,1 case became lost,1 child survived with tumor,3 cases died and the remainders survived without tumor.Serum creatinine and urea nitrogen were both within a normal range during follow-ups.Conclusion NSS may be re-performed for recurrent bilateral Wilms tumor.In conjunctions with intensive chemotherapy,the prognosis is still relatively decent.
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Memo
收稿日期:2022-6-4。
通讯作者:张潍平,Email:zhangwpp@163.com