{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T21:18:37Z","timestamp":1779225517157,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>If Wilms tumor (WT) rupture is suspected preoperatively, it is unclear whether preoperative chemotherapy (preop\u2010CT) can be safely given and whether such patients need to be treated according to local stage III postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed characteristics, treatment, and outcome of patients with preoperative rupture suspected by imaging and clinical symptoms in 119 patients from Germany, Austria, and Switzerland with unilateral WT treated within SIOP studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was no difference in age and gender distribution compared with the overall cohort of patients with WT. The general health condition was characterized at least severely impaired (37.8%). Eighty\u2010nine patients 89 (74.8%) received preop\u2010CT and 30 (25.2%) had upfront surgery. The mean tumor volume at diagnosis undergoing preop\u2010CT was 605\u00a0mL compared with 312\u00a0mL at primary surgery. Metastases were found in 20 out of 89 (22.5%) and two out of 30 (6.7%) patients, respectively. After preop\u2010CT, 31 patients (34.8%) had local histological stage I, 16 (18.0%) had stage II, 41 (46.1%) had stage III, and one (1.1%) had unknown. Low risk histology was diagnosed in seven (7.9%), intermediate risk in 65 (73.0%), and high risk in 17 (19.1%) patients. After preop\u2010CT, nine patients relapsed (10.1%), compared with four (13.3%) after primary surgery. Relapses were independent of local radiotherapy. Altogether seven patients died. A total of 14 out of 31 patients (45.2%) with overall local stage I of intermediate risk after preop\u2010CT received only 4 weeks AV without radiotherapy after surgery with 100% relapse\u2010free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preop\u2010CT can be given safely, and postoperative treatment can follow the histological staging and risk group, given that a thorough review of the specific situation is done.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.32111","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T05:10:30Z","timestamp":1760073030000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy of Preoperative Chemotherapy in Patients With Nephroblastoma and Imaging Findings Suggestive of Preoperative Tumor Rupture"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3891-580X","authenticated-orcid":false,"given":"Marvin","family":"Mergen","sequence":"first","affiliation":[{"name":"Department of Paediatric Haematology and Oncology Saarland University Hospital  Homburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2248-323X","authenticated-orcid":false,"given":"Norbert","family":"Graf","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology and Oncology Saarland University Hospital  Homburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9874-4726","authenticated-orcid":false,"given":"Nils","family":"Welter","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology and Oncology Saarland University Hospital  Homburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2305-8857","authenticated-orcid":false,"given":"Patrick","family":"Melchior","sequence":"additional","affiliation":[{"name":"Radiation Oncology Saarland University Hospital  Homburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4138-4536","authenticated-orcid":false,"given":"Christian","family":"Vokuhl","sequence":"additional","affiliation":[{"name":"Section of Pediatric Pathology, Department of Pathology University Hospital Bonn  Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9775-0403","authenticated-orcid":false,"given":"Andreas","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Pediatric Urology University Children's Hospital, Eberhard Karls University T\u00fcbingen  T\u00fcbingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3009-1153","authenticated-orcid":false,"given":"Sabine","family":"Kroiss\u2010Benninger","sequence":"additional","affiliation":[{"name":"Department of Oncology University Children's Hospital Z\u00fcrich  Z\u00fcrich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4954-6488","authenticated-orcid":false,"given":"Leo","family":"Kager","sequence":"additional","affiliation":[{"name":"Department of Pediatrics St. Anna Children's Hospital Medical University Vienna and St. Anna Children's Cancer Research Institute  Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0588-0225","authenticated-orcid":false,"given":"Jens\u2010Peter","family":"Schenk","sequence":"additional","affiliation":[{"name":"Division of Pediatric Radiology Department of Diagnostic and Interventional Radiology University Hospital Heidelberg  Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1967-8343","authenticated-orcid":false,"given":"Rhoikos","family":"Furtw\u00e4ngler","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology and Oncology Saarland University Hospital  Homburg Germany"},{"name":"Divison of Paediatric Haematology and Oncology, Department of Paediatrics Inselspital University Hospital  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.31226"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23535"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12120670"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27674"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0094\u20100143(05)70092\u20106"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2017.163"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247\u2010019\u201004423\u20103"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.30004"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","unstructured":"M. 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F.Tournade P.Bey et\u00a0al. \u201cAbdominal Recurrences in Wilms' Tumours: A Report From the SlOP Wilms' Tumour Trials and Studie \u201d (1986): 175\u2013182 https:\/\/doi.org\/10.1002\/pbc.30004.","DOI":"10.1016\/S0167-8140(86)80047-0"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199902000\u201000019"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.1276"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41585-018-0100-3"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0164643"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20049"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctro.2021.03.001"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102005\u2010858836"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00117\u2010021\u201000864\u2010w"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-020-02475-w"},{"key":"e_1_2_10_20_1","first-page":"822","article-title":"Significance of Lymph Node Involvement in Nephroblastoma","volume":"55","author":"Grundy P.","year":"2010","journal-title":"Pediatric Blood & Cancer, Abstracts of 42nd Congress of the International Society of Paediatric Oncology"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.32111","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T12:44:28Z","timestamp":1767962668000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.32111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,9]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/pbc.32111"],"URL":"https:\/\/doi.org\/10.1002\/pbc.32111","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,9]]},"assertion":[{"value":"2025-07-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e32111"}}