How are bilateral Wilms tumors treated?

Updated: Feb 01, 2019
  • Author: Tunc Ozan, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
  • Print
Answer

Answer

With bilateral Wilms tumor (6% of cases), surgical exploration, biopsy of both sides, and accurate surgical staging (including lymph node biopsy of both sides) are performed. This is followed by 6 weeks of chemotherapy that is appropriate to the stage and histology of the tumor. Reassessment is then performed using imaging studies, followed by definitive surgery with one of the following:

  • Unilateral radical nephrectomy and partial nephrectomy on the contralateral side

  • Bilateral partial nephrectomy

  • Unilateral nephrectomy only, if the response was complete on the opposite side

This approach dramatically reduces the renal failure rate following bilateral Wilms tumor therapy.The overall 2-year survival rate is higher than 80% with this approach, and the nephrectomy rate drops by 50% in patients with bilateral Wilms tumor. Bilateral partial nephrectomy is possible after chemotherapy or, if the tumor on one side responds completely to chemotherapy, with no subsequent need for nephrectomy.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!