Introduction: Wilms tumor is the most common malignant renal tumor in children. The SIOP-2016 protocol emphasizes neoadjuvant chemotherapy to reduce tumor size, facilitate surgical resection, and minimize surgical complications. However, studies evaluating the SIOP-2016 protocol in Vietnam remain limited. The aim of this study was to evaluate the surgical outcomes and postoperative complications of children with Wilms tumor treated according to the SIOP 2016 protocol at Children's Hospital 2.
Methods: This descriptive case series included 52 patients under 16 years of age with Wilms tumor who received neoadjuvant chemotherapy followed by surgical tumor resection according to the SIOP-2016 protocol at Children’s Hospital 2 from January 2018 to December 2024. Statistical analysis was performed using SPSS version 26.0, with a significance level of p < 0.05.
Results: Forty-eight of 52 patients (92.3%) received preoperative chemotherapy. The remaining four patients (7.7%) underwent emergency surgery due to tumor rupture at presentation and therefore did not receive preoperative chemotherapy. Among patients who received preoperative chemotherapy, the mean tumor volume decreased significantly from 357.1 cm³ to 224.3 cm³ after treatment (p < 0.05). Regarding surgical management, 98.1% of patients underwent total nephrectomy of the affected kidney. The overall intraoperative complication rate was 11.5%, and no postoperative mortality was observed.
Conclusions: The application of neoadjuvant chemotherapy according to the SIOP-2016 protocol demonstrates effectiveness in significantly reducing tumor size. Total nephrectomy is a safe procedure with a low complication rate, confirming its central role in the multimodal treatment approach.