PRE OPERATIVE CHEMOTHERAPY IN WILMS TUMOUR– ITS EFFECTIVENESS – A PROSPECTIVE INSTITUTIONAL STUDY

Dr.SARWESWAR REDDY PORLA; Dr. LEELA KUMAR VALLAMSETTY; Dr.BHUVANESHWAR RAO

Volume : V, Issue : XI, November - 2015

PRE OPERATIVE CHEMOTHERAPY IN WILMS TUMOUR– ITS EFFECTIVENESS – A PROSPECTIVE INSTITUTIONAL STUDY

Dr. Sarweswar Reddy Porla, Dr. Leela Kumar Vallamsetty, Dr. Bhuvaneshwar Rao

Abstract :

Purpose : NWTS(National Wilms Tumour Study )currently describes following indications for pre operative chemotherapy. • Extensive Vena Caval Involvement • Bilateral Tumours • Single Kidney • Stage Iv Disease However tumour size and incidence of tumour spillage has not been addressed for pre operative CT. Methods : We have done a prospective study at our institute to see the advantages of complete tumour excision without rupture , decrease in size of tumour with 6 weeks of pre op CT in 20 patients. Details of initial evaluation ,pre op CT, pathological findings and surgical resection constitute this report. Results : • All our patients who received pre op CT underwent complete surgical resection. • Incidence of tumour rupture was less than 10 %. • Significant shrinkage of tumour size was noted in more than 90 percent of cases. • Post operative histology showed negative tumour margins in most of the cases. • Downstaging of histology noted. • There was no requirement of post operative radiotherapy in majority of cases in our study. Conclusions: Pre op CT allowed for complete tumour resection with negative margins, reduced incidence of tumour rupture and reduced need for post operative radiotherapy.