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01.12.2023 | Original Article

RENAL nephrometry scoring system in bilateral Wilms tumor: predictive application

verfasst von: Pengfei Gao, Hong Jiang, Chenglin Wu, Longshan Liu, Mingchuan Huang, Qian Fu, Juncheng Liu, Jun Li, Huanxi Zhang, Changxi Wang

Erschienen in: Pediatric Surgery International | Ausgabe 1/2023

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Abstract

Aim

This study aims to explore the application of RENAL nephrometry scoring system in bilateral Wilms tumor (BWT).

Methods

A retrospective review of patients with BWT from January 2010 to June 2022 was performed. Each kidney unit of the BWT was evaluated independently and scored according to RENAL nephrometry scoring system by 2 blinded reviewers, and reviewers were blinded to what surgery the patients ultimately had. Discrepancies were evaluated by a third reviewer to reach a consensus. Tumor anatomical characteristics were summarized and compared.

Results

29 patients with 53 kidney units were included in the study. 53 kidney units included 12 (22.6%) low-complexity, 9 (17.0%) intermediate-complexity, and 32 (60.4%) high-complexity. 2 kidney units (3.8%) had tumor thrombus, and 14 (26.4%) had multiple lesions. A total of 42 kidney units (79.2%) underwent initial nephron-sparing surgery (NSS) and 11 (20.8%) underwent radical nephrectomy. Less complexity tumors were observed in the NSS group. Of the 42 kidney units undergoing initial NSS, 26 were performed in vivo and 16 ex vivo via autotransplantation. The latter group featured a higher complexity. During follow-up, 22 patients survived and 7 died, no statistically significant tumor complexity was observed between the two groups.

Conclusions

The anatomical characteristics of BWT are complex. Despite this study did not indicate that the complexity correlates with prognosis, low-complexity tumors were candidates for NSS, and kidney autotransplantation provided a feasible procedure for high-complexity tumors. A refined system is required due to multiple lesions and tumor thrombus.

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Titel: RENAL nephrometry scoring system in bilateral Wilms tumor: predictive application
verfasst von: Pengfei Gao
Hong Jiang
Chenglin Wu
Longshan Liu
Mingchuan Huang
Qian Fu
Juncheng Liu
Jun Li
Huanxi Zhang
Changxi Wang
Publikationsdatum: 01.12.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 1/2023
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-023-05500-3

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RENAL nephrometry scoring system in bilateral Wilms tumor: predictive application

Abstract