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S11-4
(PP)
LONG TERM RENAL FUNCTION PRESERVATION IN CHILDREN TREATED FOR
BILATERAL WILMS TUMOR.
Ricardo DUARTE
1
, Lilian CRISTOFANI
2
, Francisco DENES
1
, Vicente ODONE-FILHO
2
and Miguel SROUGI
1
1) University of Sao Paulo, Urology, Sao Paulo, BRAZIL - 2) University of Sao Paulo, Pediatric Oncology, Sao Paulo,
BRAZIL
PURPOSE
Bilateral Wilms’ tumor represents a challenging situation. Our purpose was to evaluate the success of renal function
preservation and cure in these patients.
MATERIAL AND METHODS
From January/1982 through March/2014, 19 children with bilateral Wilms’ tumor were diagnosed. All patients received
preoperative chemotherapy and were submitted to surgical procedure with nephron sparing objective. The renal function
was assessed by glomerular filtration rate (Schwartz), creatinine level and microalbuminuria/creatinine index.
RESULTS
Radical unilateral nephrectomy was performed in 10 patients combined with contralateral nodulectomy in 7,associated
with partial contralateral in one and two patients presented unilateral disappearing of the disease after preoperative
chemotherapy on image and surgical evaluation. Six patients had bilateral nodulectomy, two had partial bilateral
nephrectomy and one had partial nephrectomy plus contralateral noduletomy.
Five patients relapsed: 3 in the remaining kidney, 1 in the tumoral bed and 1 in lungs (9mo, 1mo, 5mo and 6 mo after
surgery). Two of them were rescued, achieving a second remission and three died of progressive disease.
16/19 patients are alive and with normal renal function by GFR (glomerular filtration rate), creatinine level and
microalbuminuria analysis. 1/19 patients required hemodialysis support and died of progressive disease before a kidney
transplant was performed. 16/19 patients are alive and free of disease for 13+ months to 30 +years.
CONCLUSIONS
The renal function was preserved in all 16/19 of surviving patients treated for bilateral Wilms’ tumor, avoiding dialysis
support. The overall survival was 84.2% in five years and 71% in ten years.