Contralateral Surgical Exploration in Unilateral Wilms' Tumor / 대한비뇨기과학회지

ABSTRACT

Contralateral exploration has become standard treatment of the unilateral Wilms' tumor. The current preoperative imaging modalities including CT and ultrasonography are far superior to the IVP at detecting contralateral disease in unilateral Wilms' tumor. The question must then be posed whether contralateral exploration is still indicated in patient with negative preoperative imaging studies. We reviewed 18 patients of Wilms' tumor seen at our hospital from 1980 to 1995. All 18 patients had unilateral disease in the preoperative CT and/or ultrasonography. Contralateral exploration was done in the early 3 patients (1980-1985). The results of imaging studies were confirmed on surgical exploration. The remaining 15 patients were not explored because the contralateral tumor was not found in the preoperative CT and ultrasonography. During the periodic follow-up with CT, 5 patients with high stage (III,IV) and/or unfavorable histology were early expired. Two patients were not evaluable owingto short follow-up duration. The remnant 8 patients were free of disease clinically and radiologically during follow-up (mean duration 51.5 months). The current, accurate preoperative imaging modalities and effective chemotherapy suggest that contralateral surgical exploration may no longer be mandatory in patients with unilateral Wilms' tumor despite of short follow-up duration and small number of patients.