Oncologic outcomes of partial versus radical nephrectomy for unilateral Wilms Tumor

Nicholas G. Cost, Jessica D. Lubahn, Candace F. Granberg, Bruce J Schlomer, Jonathan E Wickiser, Dinesh Rakheja, Patricio C. Gargollo, David Leonard, Ganesh Raj, Linda A Baker, Vitaly Margulis

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Radical nephrectomy (RN) is the recommended surgical management as part of multi-modality therapy for unilateral Wilms tumor (UWT). Based on recent data demonstrating that renal preserving surgery decreases the likelihood of chronic renal disease and associated co-morbidities, we analyzed oncologic outcomes of patients after partial nephrectomy (PN) for UWT. Methods: We identified all published cases of PN for UWT. Cases of elective PN for UWT were analyzed for tumor stage, presence, timing and location of disease recurrence, and overall survival (OS). Eighty-two patients had adequate data for analysis. For comparison, these endpoints were collected on consecutive children undergoing RN for UWT from 1985 to 2010 at our institution. Results: Of the 82 PN patients, tumor stage was: I-64, II-10, III-6, IV-2. Of the 121 RN patients, the staging was: I-24, II-45, III-29, IV-23. In the PN group, at a median of 48 months (3-372), the recurrence-free survival (RFS), local RFS and OS were 89.1%, 92.7%, and 95.1%, respectively. In the RN group, at a median of 69 months (0-214), the RFS, local RFS, and OS were 83.1%, 95.0%, and 95.0%, respectively. After controlling for stage, there were no statistically significant differences in the above oncologic outcomes between the groups. Conclusion: Based on reported data, the oncologic outcomes of PN for UWT in selected patients do not appear to differ from those of RN. PN for appropriately selected patients with UWT should be studied in prospective, co-operative group trials.

Original languageEnglish (US)
Pages (from-to)898-904
Number of pages7
JournalPediatric Blood and Cancer
Volume58
Issue number6
DOIs
StatePublished - Jun 2012

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Wilms Tumor
Nephrectomy
Survival
Recurrence
Chronic Renal Insufficiency
Neoplasms

Keywords

  • Nephroblastoma
  • Nephron sparing
  • Partial nephrectomy
  • Pediatric renal tumor
  • Wilms tumor

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Oncologic outcomes of partial versus radical nephrectomy for unilateral Wilms Tumor. / Cost, Nicholas G.; Lubahn, Jessica D.; Granberg, Candace F.; Schlomer, Bruce J; Wickiser, Jonathan E; Rakheja, Dinesh; Gargollo, Patricio C.; Leonard, David; Raj, Ganesh; Baker, Linda A; Margulis, Vitaly.

In: Pediatric Blood and Cancer, Vol. 58, No. 6, 06.2012, p. 898-904.

Research output: Contribution to journalArticle

Cost, Nicholas G. ; Lubahn, Jessica D. ; Granberg, Candace F. ; Schlomer, Bruce J ; Wickiser, Jonathan E ; Rakheja, Dinesh ; Gargollo, Patricio C. ; Leonard, David ; Raj, Ganesh ; Baker, Linda A ; Margulis, Vitaly. / Oncologic outcomes of partial versus radical nephrectomy for unilateral Wilms Tumor. In: Pediatric Blood and Cancer. 2012 ; Vol. 58, No. 6. pp. 898-904.
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abstract = "Background: Radical nephrectomy (RN) is the recommended surgical management as part of multi-modality therapy for unilateral Wilms tumor (UWT). Based on recent data demonstrating that renal preserving surgery decreases the likelihood of chronic renal disease and associated co-morbidities, we analyzed oncologic outcomes of patients after partial nephrectomy (PN) for UWT. Methods: We identified all published cases of PN for UWT. Cases of elective PN for UWT were analyzed for tumor stage, presence, timing and location of disease recurrence, and overall survival (OS). Eighty-two patients had adequate data for analysis. For comparison, these endpoints were collected on consecutive children undergoing RN for UWT from 1985 to 2010 at our institution. Results: Of the 82 PN patients, tumor stage was: I-64, II-10, III-6, IV-2. Of the 121 RN patients, the staging was: I-24, II-45, III-29, IV-23. In the PN group, at a median of 48 months (3-372), the recurrence-free survival (RFS), local RFS and OS were 89.1{\%}, 92.7{\%}, and 95.1{\%}, respectively. In the RN group, at a median of 69 months (0-214), the RFS, local RFS, and OS were 83.1{\%}, 95.0{\%}, and 95.0{\%}, respectively. After controlling for stage, there were no statistically significant differences in the above oncologic outcomes between the groups. Conclusion: Based on reported data, the oncologic outcomes of PN for UWT in selected patients do not appear to differ from those of RN. PN for appropriately selected patients with UWT should be studied in prospective, co-operative group trials.",
keywords = "Nephroblastoma, Nephron sparing, Partial nephrectomy, Pediatric renal tumor, Wilms tumor",
author = "Cost, {Nicholas G.} and Lubahn, {Jessica D.} and Granberg, {Candace F.} and Schlomer, {Bruce J} and Wickiser, {Jonathan E} and Dinesh Rakheja and Gargollo, {Patricio C.} and David Leonard and Ganesh Raj and Baker, {Linda A} and Vitaly Margulis",
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T1 - Oncologic outcomes of partial versus radical nephrectomy for unilateral Wilms Tumor

AU - Cost, Nicholas G.

AU - Lubahn, Jessica D.

AU - Granberg, Candace F.

AU - Schlomer, Bruce J

AU - Wickiser, Jonathan E

AU - Rakheja, Dinesh

AU - Gargollo, Patricio C.

AU - Leonard, David

AU - Raj, Ganesh

AU - Baker, Linda A

AU - Margulis, Vitaly

PY - 2012/6

Y1 - 2012/6

N2 - Background: Radical nephrectomy (RN) is the recommended surgical management as part of multi-modality therapy for unilateral Wilms tumor (UWT). Based on recent data demonstrating that renal preserving surgery decreases the likelihood of chronic renal disease and associated co-morbidities, we analyzed oncologic outcomes of patients after partial nephrectomy (PN) for UWT. Methods: We identified all published cases of PN for UWT. Cases of elective PN for UWT were analyzed for tumor stage, presence, timing and location of disease recurrence, and overall survival (OS). Eighty-two patients had adequate data for analysis. For comparison, these endpoints were collected on consecutive children undergoing RN for UWT from 1985 to 2010 at our institution. Results: Of the 82 PN patients, tumor stage was: I-64, II-10, III-6, IV-2. Of the 121 RN patients, the staging was: I-24, II-45, III-29, IV-23. In the PN group, at a median of 48 months (3-372), the recurrence-free survival (RFS), local RFS and OS were 89.1%, 92.7%, and 95.1%, respectively. In the RN group, at a median of 69 months (0-214), the RFS, local RFS, and OS were 83.1%, 95.0%, and 95.0%, respectively. After controlling for stage, there were no statistically significant differences in the above oncologic outcomes between the groups. Conclusion: Based on reported data, the oncologic outcomes of PN for UWT in selected patients do not appear to differ from those of RN. PN for appropriately selected patients with UWT should be studied in prospective, co-operative group trials.

AB - Background: Radical nephrectomy (RN) is the recommended surgical management as part of multi-modality therapy for unilateral Wilms tumor (UWT). Based on recent data demonstrating that renal preserving surgery decreases the likelihood of chronic renal disease and associated co-morbidities, we analyzed oncologic outcomes of patients after partial nephrectomy (PN) for UWT. Methods: We identified all published cases of PN for UWT. Cases of elective PN for UWT were analyzed for tumor stage, presence, timing and location of disease recurrence, and overall survival (OS). Eighty-two patients had adequate data for analysis. For comparison, these endpoints were collected on consecutive children undergoing RN for UWT from 1985 to 2010 at our institution. Results: Of the 82 PN patients, tumor stage was: I-64, II-10, III-6, IV-2. Of the 121 RN patients, the staging was: I-24, II-45, III-29, IV-23. In the PN group, at a median of 48 months (3-372), the recurrence-free survival (RFS), local RFS and OS were 89.1%, 92.7%, and 95.1%, respectively. In the RN group, at a median of 69 months (0-214), the RFS, local RFS, and OS were 83.1%, 95.0%, and 95.0%, respectively. After controlling for stage, there were no statistically significant differences in the above oncologic outcomes between the groups. Conclusion: Based on reported data, the oncologic outcomes of PN for UWT in selected patients do not appear to differ from those of RN. PN for appropriately selected patients with UWT should be studied in prospective, co-operative group trials.

KW - Nephroblastoma

KW - Nephron sparing

KW - Partial nephrectomy

KW - Pediatric renal tumor

KW - Wilms tumor

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