ESPU Congress 2018 - Abstract Book

107

11–14 APRIL, 2018, HELSINKI, FINLAND

08:03–08:06

S13-2 (PP)

THE IMPACT OF NEO-ADJUVANT CHEMOTHERAPY

ON NEPHRON SPARING SURGERY AND LAPAROSCOPIC

RESECTION IN WILMS TUMOUR, A SINGLE CENTRE

EXPERIENCE

Annie ROBERTS

, Aurore BOUTY

, Michael NIGHTINGALE

, Martin CAMPBELL

and

Yves HELOURY

1) Royal Children's Hospital, Melbourne, Department of Urology, Parkville, AUSTRALIA - 2) Royal Children's Hospital,

Melbourne, Department of Paediatric and Neonatal Surgery, Parkville, AUSTRALIA - 3) Royal Children's Hospital,

Melbourne, Children's Cancer Centre, Parkville, AUSTRALIA

PURPOSE

Increasingly, the treatment of Wilms tumour is turning to optimisation of long-term outcomes such as

the rate of impaired renal function and adhesive obstruction. Increasing evidence that nephron spar-

ing surgery (NSS) and laparoscopic resection reduce these two morbidities has driven us to review

cases of Wilms in our centre from 2011–2017 to establish the impact of preoperative chemotherapy

on the use of both NSS and laparoscopic resection.

MATERIAL AND METHODS

Retrospective case review of all patients undergoing resection for histologically confirmed Wilms

tumour from January 2011– October 2017 in a single institution. Data included demographic, diag-

nostic, preoperative and postoperative information. Eligibility for laparoscopic or nephron sparing

surgery was determined using the SIOP 2014 umbrella protocol.

RESULTS

Of the 61 children reviewed, 10 underwent NSS and 22 underwent laparoscopic resection. Of the

10 patients undergoing NSS, 8 (80 %) would have been ineligible prior to neoadjuvant chemo-

therapy. Neoadjuvant chemotherapy also resulted in 9 (41 %) of the laparoscopic group being

eligible for the laparoscopic approach that would not have been amenable prior.

Median tumour volume reduction was larger in the laparoscopic group (71 %) compared to the open

group (46 %), with a similar median preoperative volume (laparoscopic 365 ml vs open 314 ml).

Conversion to open occurred in 2 cases (9 %).

CONCLUSIONS

Neoadjuvant chemotherapy increases the likelihood of successful NSS or laparoscopic resection in

Wilms tumour. This has the potential for improved long-term morbidity, adding further weight to the

argument for neoadjuvant chemotherapy.