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Review
. 2017 May 12:6:670.
doi: 10.12688/f1000research.10760.1. eCollection 2017.

Recent advances in the management of Wilms' tumor

Roberto I Lopes  1   2 , Armando Lorenzo  1   2
Affiliations
Review

Recent advances in the management of Wilms' tumor

Roberto I Lopes et al. F1000Res. .

Abstract

The objective of this article is to present an overview of recent trends in the management of Wilms' tumor. With improved survival rates in the past few decades, critical long-term adverse therapy effects (such as renal insufficiency, secondary malignancies, and heart failure) and prevention measures (i.e. nephron-sparing surgery and minimizing the use of radiotherapy) have gained worldwide attention. Specific disease biomarkers that could help stratify high-risk from low-risk patients, and therefore fine-tune management, are in great demand. Ultimately, we aim to enhance clinical outcomes and maintain or improve current survival rates while avoiding undesirable treatment side effects and minimizing the exposure and intensity of chemotherapy and radiotherapy.

Keywords: Wilms' tumor; chemotherapy; nephroblastoma; radiotherapy; surgery.

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Conflict of interest statement

Competing interests: The authors declare that they have no competing interests.No competing interests were disclosed.No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. Laparoscopic nephrectomy after chemotherapy.
A. Large left renal mass; B. shrinkage of the tumor after chemotherapy, although it is still not amenable for a partial nephrectomy; C. left laparoscopic transperitoneal radical nephrectomy; D. dissection of renal artery and vein; E. final cosmetic result.
Figure 2.
Figure 2.. Zero-ischemia laparoscopic assisted open partial nephrectomy.
A. Lower pole right renal tumor; B. laparoscopic mobilization of the kidney, especially the lower pole tumor; C. subcostal incision guided by laparoscopy (light coming from the abdomen); D. mobilization of the lower pole tumor (reducing risks of tumor spill)—note the presence of vessel loops placed laparoscopically (as a safety resource for bleeding control); E. intra-operative ultrasonography helps define the tumor and aids the identification of a margin-free resection; F. ultrasonographic view of the tumor.
See this image and copyright information in PMC

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