Table 2 Potential clinical advantages and disadvantages of Wilms’ tumor resection strategies
Advantages | Disadvantage | |
|---|---|---|
Upfront resection | Avoid misdiagnosis Avoid chemotherapy in Stage 1 | Tumor rupture Complications |
Delayed resection | Low risk of tumor rupture Nephron sparing resection MIS | Chemotherapy may not be indicated, or wrong chemotherapy may be given Under staging Dependent on availability of chemotherapy Tumor biology may be less chemosensitive in some populations |
Customized approach | Avoid misdiagnosis Avoid overtreatment Decrease incidence of rupture and complications | Criteria to stratify (clarity, implementation, and validation) Small tumors are also at risk of rupture Requires imaging diagnostic capacity |