Our Six-year Wilms Tumor Results: A Single-center Experience

Objective: This study aimed to analyze the demographic, clinical, and pathological data of children diagnosed with Wilms tumor (WT) and operated on at a tertiary healthcare center. Method: Our study is a retrospective, observational analysis of clinical records of patients diagnosed with WT at a tertiary pediatric center between May 2017 and June 2023. The patients were evaluated based on their age at diagnosis, gender, symptoms, associated anomalies, laboratory and radiological examinations, the affected kidney side, stage, postoperative treatment, and follow-up. Histopathological classifications and staging for all patients were performed according to the National Wilms Tumor Study Group (NWTSG). Chemotherapy treatment was determined based on the pathological stages and tumor histopathology. In cases with metastasis, if clinically appropriate, metastasectomy was performed and chemotherapy was administered. Treatment for recurrence included surgery, chemotherapy, and radiotherapy. Results: The average age of these patients was 3.8 years, with an equal distribution of male and female patients. The most common symptoms were abdominal mass, hematuria, and fever. Right kidney involvement was found in 50% of patients, left kidney involvement in 40%, and bilateral involvement in 10%. Treatment protocols were determined according to the NWTSG guidelines, with unilateral radical nephrectomy performed on all patients except two, who received preoperative chemotherapy. Pathological evaluation revealed that all patients had nephroblastoma (triphasic type), with anaplastic features found in three patients. Two patients presented with pulmonary metastases. With an average follow-up of 2.15 years, no recurrences were observed during the study. Conclusion: WT treatment should be approached with a multidisciplinary strategy and executed with careful surgical techniques. This study supports the effectiveness of current methods in the treatment of WT and highlights their positive impact on survival rates.