title: Minimally invasive nephrectomy for Wilms tumors in children - data from SIOP 2001.
abstract: OBJECTIVE
  To analyse the surgical and oncological outcome of minimally invasive surgery (MIS) for tumor nephrectomy in Wilms tumor (WT) patients.
  
  
  METHODS
  WT patients from the SIOP 2001 trial, undergoing MIS for tumor nephrectomy were analyzed with regard to demographic characterization, surgical specifications, complications, and outcome.
  
  
  RESULTS
  There were 24 children matching the inclusion criteria. Median age at operation was 40.35 months (14.3-65.4). All patients received preoperative chemotherapy. Median tumor volume was 177.5 ml at diagnosis (46.5-958) and 73.0 ml at surgery (3.8-776). There was one surgical complication (splenic injury), no intraoperative tumor rupture occurred. Abdominal stage was I in 14, II in 7, and III in 3 patients. Adequate lymph node sampling was performed in only 2 patients. One local relapse occurred. Event-free survival was 23/24, overall survival was 24/24, median follow up was 47 months (2-114).
  
  
  CONCLUSIONS
  We present the largest series so far of minimally invasive nephrectomies for nephroblastoma based on a multinational trial. Treatment results were comparable to those of open surgery; however, experience of operating surgeons was generally high. Discipline of lymph node sampling was inadequate. Based on this analysis a prospective study on MIS in nephroblastoma is planned by the SIOP Renal Tumor Study Group.
authors.affiliation: Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Germany. Electronic address: steven.warmann@med.uni-tuebingen.de.
authors.forename: Steven W
authors.initials: SW
authors.lastname: Warmann
authors.affiliation: Department of Pediatric Surgery, Marciniak Hospital, Wroclaw and Chair of Emergency Medicine, Medical University, Wroclaw, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Godzinski
authors.affiliation: Comprehensive Cancer Centre, Amsterdam, The Netherlands.
authors.forename: Harm
authors.initials: H
authors.lastname: van Tinteren
authors.affiliation: Pediatric Surgical Center of Amsterdam (ECH-AMC/VUmc), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Hugo
authors.initials: H
authors.lastname: Heij
authors.affiliation: Department of Paediatric Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Powis
authors.affiliation: Childhood Cancer Research Unit, Astrid Lindgren's Children's Hospital, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Sandstedt
authors.affiliation: Department of Pediatric Hematology and Oncology, University Hospital Homburg/Saar, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Graf
authors.affiliation: Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Fuchs
mesh_terms: D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods*; D009426:Netherlands; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000601:surgery*
keywords: Laparoscopy; Nephroblastoma; Tumor resection