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SURGICAL MANAGEMENT, STAGING, AND OUTCOMES OF WILMS TUMOURS WITH INTRAVASCULAR EXTENSION: RESULTS OF THE IMPORT STUDY

Space: StayCurrentMD Author: Kristina Dzhuma, Mark Powis, Gordan Vujanic, Tom Watson, Oystein Olsen, Susan Shelmerdine, Minou Oostveen, Jesper Brok, Sabine Irtan, Richard Williams, Suzanne Tugnait, Naima Smeulders, Imran Mushtaq, Tanzina Chowdhury, Reem Al-Saadi, Kathy Pritchard-Jone Published:

Author / Expert

Kristina Dzhuma, Mark Powis, Gordan Vujanic, Tom Watson, Oystein Olsen, Susan Shelmerdine, Minou Oostveen, Jesper Brok, Sabine Irtan, Richard Williams, Suzanne Tugnait, Naima Smeulders, Imran Mushtaq, Tanzina Chowdhury, Reem Al-Saadi, Kathy Pritchard-Jone

Topic overview

ABSTRACT

Purpose

to review surgical management, tumour stage and clinical outcomes in children with intravascular extension of Wilms tumour (WT) registered in a national clinical study (2012-19).

Methods

WTs with presence/suspicion of tumour thrombus in the renal vein (RV) or beyond on radiology, surgery or pathology case report forms were identified. Only cases where thrombus was confirmed by surgeon and/or reference pathologist were included. Surgical management, disease stage, overall (OS) and event free survival (EFS) were investigated.

Results

69/583 (11.8%) patients met the inclusion criteria. Forty-six (67%) had abdominal stage III due to thrombus-related reasons: 11 had macroscopically incomplete resection, including 8 cases where cavotomy was not performed; 20 had piecemeal complete resection of thrombus; 15 had microscopically positive resection margins at the RV. 66% of tumour thrombi contained viable tumour. There were eight relapses and five deaths. EFS, but not OS, was significantly associated with completeness of surgical resection (P

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