Treatment of Wilms Tumor in Children with Localized Bilateral Renal Tumors (Favorable Histology)

This protocol addresses children presenting with localized bilateral renal tumors of favorable histology (Wilms tumor), with or without an underlying predisposing condition. Bilateral disease requires a treatment strategy that balances effective tumor control with preservation of renal function.

The recommended first-line approach involves neoadjuvant chemotherapy administered before surgery, followed by tumor reassessment to determine whether nephron-sparing surgical resection has become feasible. The complete regimen, response criteria, and surgical decision points are specified in the full protocol.

The primary aim is sufficient tumor reduction to enable resection while preserving as much renal parenchyma as possible. Tumor response at a defined treatment interval serves as the critical milestone that guides the surgical path.