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  1 , Aurore BOUTY  1 , Michael NIGHTINGALE  2 , Martin CAMPBELL  3 and Yves HELOURY  1 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.