Childhood renal tumors: surgical treatment and results

Abstract

Aim: Renal tumors in children are rare. Wilms' tumor (WT) is the most common renal tumor in childhood. The aim of this study is to investigate the data on the demographic factors, treatment, and follow-up results of pediatric patients who were operated on for renal tumors and determine the factors affecting mortality. Material and Method: Patients who were operated for renal tumor in our clinic in 2005-2020 were evaluated retrospectively. Age at diagnosis, gender, complaint, localization of the involved kidney, additional anomalies, tumor size, tru-cut biopsy performed, tumor stage, distant metastasis, applied treatments, pathology, treatment complications, and follow-up period were examined. Results: Of the 47 patients, 25 were female and 22 were male. The mean age was 45.46 (2-204) months. The tumor was located in the right in 21 cases, left in 23 cases and bilateral in three cases. The mean length of the tumor was 11.73 cm. At the time of diagnosis, there was metastasis in 15 cases (31.9%). While metastasis were the most common seen in lung (24.3%), bone-cell metastases were seen in clear cell carcinoma (33.3%) and brain metastases were seen in rhabdoid tumor (50%). Tru-cut biopsy was performed in 15 (31.9%) cases and biopsy was diagnostic in ten cases. Histopathologically, 41 cases had WT (87.23%), three cases were clear cell carcinoma (6.3%), two cases had anaplasia rhabdoid tumor (4.2%), and one case had metanephric adenoma. Relaps occured in nine cases (19.14%) during the follow-up period. Histopathologically, one case was a clear cell carcinoma, one case was a rhabdoid tumor, and seven cases were unilateral WT. The survival rate of our series was 89,4%. Conclusion:The most common renal tumor in childhood was WT. Surgery have no effect on survival; the most important survival factors were detecting the existence of rhabdoid tumors and anaplasia histopathologically. Therefore, during the followup and treatment of renal tumors in childhood, pathological examination should be of primary importance and followed up with the pediatric oncologists.