Synchronous Bilateral Wilms Tumor: Surgical Evaluation and Survival

Abstract

Introduction: Kidney tumors account for about 7% of all childhood malignancies. Synchronous bilateral Wilms  tumor corresponds to 5-7% of all nephroblastomas. The treatment consists of preoperative chemotherapy, followed by conservative surgery, postoperative chemotherapy and, when indicated, radiotherapy. Objective: To analyze the type of surgery and the overall survival of patients with synchronous bilateral Wilms tumor. Method: This retrospective cohort study included 18 pediatric patients from the Hospital do Cancer I, from the National Cancer Institute José Alencar Gomes da Silva, in Rio de Janeiro, from January 2000 to december 2017. Survival curves were calculated using the Kaplan-Meier method. Results: The median age at diagnosis was 19 months, and 10 patients were female. It was possible to perform conservative surgery in 62.5% of the kidneys, and in 41.2% (7/17) of patients in both kidneys. The 5-year overall survival according to the type of surgery was 87.5% for conservative surgery and 62.8% for radical nephrectomy (p=0.0001). The 5-year overall survival of the entire cohort was 70.8%. Conclusion: Conservative surgery in pediatric synchronous bilateral Wilms tumor is feasible and can be performed safely in reference centers.