Management of Wilms’Tumor: a narrative review

Abstract

Objective: Describe and review the Wilm’s Tumor (WT), with an emphasis on surgical treatment and discuss pre or post-surgical chemotherapy and the necessary tests, according to the most current guidelines available. Bibliographic review: WT is an embryonic tumor derived from the metanephros, precursor cells of the kidney. It is the most common kidney tumor in childhood and the third most common pediatric malignancy. Its treatment is essentially surgical, with or without chemotherapy, according to the protocols Children's Oncology Group (COG) and International Society of Pediatric Oncology (SIOP). Radiographic and pathological criteria are used to assess preoperative viability, indicating suitable candidates for each surgery. Radical nephrectomy is the treatment of choice in cases of unilateral tumor. In cases of bilateral tumors, partial nephrectomy associated with the nephron-sparing surgery technique is chosen, aiming to preserve renal function. There is a consensus in the literature that screening and early diagnosis leads to a better prognosis and reduces morbidity and mortality. Final considerations: It is concluded that the study of WT is extremely necessary, given its worldwide epidemiological importance. The development of protocols such as COG and SIOP are of great value for advancing the treatment of these tumors.