• Ruqayya Manzoor Children's Hospital, Pakistan Institute of Medical Sciences, Islamabad
  • Nuzhat Yasmeen Childrens Hospital, Pakistan Institute of Medical Sciences, Islamabad


Background: Wilms tumour is the most common renal tumour in paediatric age group. This study was done to compare the two approaches used for treatment, namely upfront nephrectomy versus pre-operative chemotherapy. Methods; A descriptive cross-sectional study was done enrolling all the patients of Wilms tumour reporting to Oncology unit Children’s Hospital during the study period. A total of 80 patients were divided into 2 groups. One group (n=40) had upfront surgery while the other (n=40) received pre-op chemotherapy before surgery. Both groups were compared for outcomes including whether treatment completed and declared cured, lost during treatment against medical advice, or died during treatment.  Results; It was found that stage 2 patients were more likely to get upfront surgery done while stage 3,4 and 5 were likely to get pre-operative chemotherapy before nephrectomy. Also, favourable histology was associated with better outcome overall outcome.Keywords: Wilms tumour; Nephrectomy; Chemotherapy; Preoperative Chemotherapy


Lazarus J, Kaestner L. Wilm’s tumour- an update. J Pediatr Sci 2010;2(3):e26.

Meshref M, Alsherif S, Kadah S. Comparative Study on the Effect of Preoperative Chemotherapy as Recommended in the SIOP Protocols versus the Standard Upfront Surgical Resection in Cases of Stage I, II and Resectable Stage III as Recommended by the NWSG on the Surgical Outcome, Rate of Intra and Postoperative Complication and Percentage of Down Staging in Pediatric Wilm’s tumour. Med J Cairo Univ 82(2):2014;117–22.

Ahmed HU, Arya M, Tsiouris A, Sellaturay SV, Shergill IS, Duffy PG, et al. An update on the management of Wilm’s tumour. Eur J Surg Oncol 2007;33(7):824–31.

Varan A. Wilms’ tumour in children: an overview. Nephron Clin Pract 2008;108(2):c83–90.

Lee SB, Harber DA. Wilms’ tumour and the WT1 gene. Exp Cell Res 2001;264(1):74–99.

Bhatnagar S. Management of Wilm’s tumour: NWTS vs SIOP. J Indian Assoc Pediatr Surg 2009;14(1):6–14.

Gleason JM, Lorenzo AJ, Bowlin PR, Koyle MA. Innovations in the management of Wilms’ tumour. Ther Adv Urol 2014;6(4):165–76.

Campbell MF, Wein AJ, Kavoussi LR, Walsh PC. Campbell-Walsh Urology. Philadelphia: Saunders Elsevier; 2007.

Ko EY, Ritchey ML. Current management of Wilms tumour in children. J Pediatr Urol 2009;5(1):56–65.