Effect of Preoperative Chemotherapy on Outcome of Wilms Tumor / 임상소아혈액종양

ABSTRACT

BACKGROUND: Wilms tumor is the most common renal tumor in children. The aim of this study was to assess the effect of preoperative chemotherapy after needle biopsy on outcome of Wilms tumor and suggest an optimal treatment scheme on Wilms tumor. METHODS: We reviewed the medical records of 52 patients who were diagnosed with Wilms tumor from 1995 to 2010. Before 2000, primary nephrectomy was usually done. After 2000, preoperative chemotherapy was usually done. RESULTS: Preoperative chemotherapy was given to 39 cases while primary nephrectomy was done in 13 cases. Five year survival rate and five year event-free survival rate were 96.2+/-2.7% and 87.9+/-4.7%, respectively. Tumor spillage occurred more frequently in primary nephrectomy group than in preoperative chemotherapy after needle biopsy group (P=0.014). There was no significant difference in survival between the two groups (P=0.599). CONCLUSION: Preoperative chemotherapy after needle biopsy improved diagnostic accuracy and decreased tumor spillage while strengthened chemotherapy intensity. Further studies are needed to optimize chemotherapy intensity.