Kay R, Tank E
J Urol. 1986 May;135(5):983-5. doi: 10.1016/s0022-5347(17)45947-7.
The good prognosis of synchronous bilateral Wilms tumor seems inappropriate for the magnitude of the disease process. Our experience with 11 cases demonstrates the unusual tumor response to chemotherapy and limited preservative surgery. Although 2 patients died 2 with metastatic disease have responded to chemotherapy and are alive at 5 and 8 years after treatment. In addition, 1 patient has survived with biopsy only and no definitive surgery. Although all surgical options have been used, ranging from biopsy alone to bench surgery with autotransplantation to bilateral nephrectomy, our experience demonstrates the effectiveness of a conservative approach with initial biopsy, chemotherapy and subsequent partial nephrectomy if needed. Our survival data and the histological examination of the tumors after chemotherapy suggest a strong relationship of bilateral Wilms tumor to the nodular renal blastema-nephroblastomatosis complex, and a mechanism to explain the excellent tumor response to chemotherapy.
同步双侧肾母细胞瘤的良好预后似乎与疾病进程的严重程度不相称。我们对11例患者的经验表明，该肿瘤对化疗及有限的保留性手术有异常反应。尽管有2例死于转移性疾病的患者对化疗有反应，且在治疗后5年和8年仍存活。此外，1例患者仅通过活检存活，未进行确定性手术。尽管已采用了所有手术方式，从单纯活检到带自体移植的平台手术再到双侧肾切除术，但我们的经验表明，采取初始活检、化疗以及必要时后续行部分肾切除术的保守方法是有效的。我们的生存数据以及化疗后肿瘤的组织学检查表明，双侧肾母细胞瘤与结节性肾胚基-肾母细胞瘤病复合体有密切关系，并且有一种机制可以解释肿瘤对化疗的良好反应。
