Wilms Tumor and Its Management in a Surgical Aspect

Abstract

Nephroblastoma [Wilms tumor (WT)] is a rare, but the most common, primary renal tumor in children. WT is usually diagnosed between the ages of 1 and 5, with the most common diagnosis at the age of 3. While imaging (ultrasound, computed tomography, and magnetic resonance) can accurately predict up to 95% of WTs, they cannot predict the histologic subtypes and require tissue examination. Surgery is one of the cornerstones of WT treatment. Other aspects of management include chemotherapy and radiation therapy. The Societe Internationale D'oncologie Pediatrique (SIOP) advocates primary chemotherapy in patients less than 6 months of age, whereas the Children's Oncology Group (COG) recommends primary surgery in all cases except those considered not resectable by the surgeon. In this chapter, the surgical therapy of WT is reviewed.