Wilms' tumor

Abstract

Although chemotherapy has improved the outcomes of Wilms' tumor treatment, surgical resection of the tumor and surgical staging play the most important roles on the management of disease. When preoperative evaluation shows the possibility of complete resection of the tumor, biopsy of the tumor may not be needed. Regional or aggressive lymph node dissection is not required, lymph node sampling for surgical staging plays important roles for the subsequent treatment plan. If evaluations using such as enhanced CT scan or MRI fail to show the bilateral lesions in the kidneys, surgical exploration of the contra-side may not be mandatory. In the case with bilateral Wilms' tumor, chemotherapy and nephron-sparing surgery should be considered. Tumor rupture or spillage during operation migrates the tumor staging, adversely.