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CONGRESS OF THE ESPU
08:08–08:11
S13-4 (PP)
ARE THE SIOP CRITERIA OF LAPAROSCOPIC TOTAL
NEPHRECTOMY FOR WILMS TUMOR APPROPRIATE?
Aurore BOUTY
1
, Annie ROBERTS
1
, Alice FAURE
1
, Mike O’BRIEN
1
,
Michael NIGHTINGALE
1
and Yves HELOURY
2
1) Royal Children’s Hospital, Urology, Parkville, AUSTRALIA - 2) Royal children’s hospital, Pediatric urology, Parkville,
AUSTRALIA
PURPOSE
In the Umbrella SIOP protocol, total nephrectomy by laparoscopy is a surgical option.
The criteria for laparoscopy are: no preoperative rupture; no invasion of surrounding organs; no in-
travascular thrombus; no massive invasion of the hilum; tumor not extending beyond the ipsilateral
border of the vertebral body.
The goal of this study was to determine the results of total nephrectomy by laparoscopy wether the
SIOP criteria were respected or not.
MATERIAL AND METHODS
A retrospective study (2011-2016) of the patients operated by laparoscopy for Wilms tumor was
performed. All the patients were treated by 4 weeks of preoperative chemotherapy. The following
items were selected: respect of the SIOP criteria; volume of the tumor on the preoperative CT scan;
peroperative rupture; conversion rate; postoperative staging; histology; recurrence.
RESULTS
44 patients were operated for a Wilms tumor; 14 by laparosocopy.
In 8 cases, the SIOP criteria were respected. The median volume of the tumor was 181 ml (50-367).
No peroperative rupture or conversion occurred. The staging was: 7 stage I; 1 stage II. Seven
patients had a standard histology and 1 a diffuse anaplasia. One local recurrence happened at
9 months (stage I with standard histology).
In 6 cases, the SIOP criteria were not respected: 1 preoperative rupture; 5 tumors extending beyond
the lateral border of the vertebra ( 2 crossing the midline). The median volume was 378 ml (126-466).
No peroperative rupture but 1 conversion to open surgery. The staging was: 1 stage I; 4 stage II;
1 stage III (preoperative rupture). All the patients had a standard histology. No recurrence occurred.
With the progressive modification of the indications, between 2014 to 2016, 14 patients over
24 (58.3%) were operated by laparosocopy.
CONCLUSIONS
The SIOP criteria for laparoscopy are conservative in order to maintain an excellent oncological
result. Some tumors medial to the lateral border of the vertebral body can be operated safely by
laparoscopy.
08:11–08:20
Discussion