The impact of hepatic resection for liver metastases (LM) on the survival of pediatric patients with Wilms’ tumor (WT) is unclear. So far, there is a lack of studies investigating the best suited treatment for patients with WTLM, and the role of liver resection has rarely been investigated. Thus, the development of evidence-based guide‑ lines concerning indications of liver resection for WTLM remains difficult. | Fuchs et al. BMC Cancer 2022 22 76 https s12885-022-09182-3 RESEARCH Open Access The role of liver resection in metastatic nephroblastoma a systematic review and Meta regression analysis Juri Fuchs1 Anastasia Murtha Lemekhova1 Markus Kessler2 Patrick Günther2 and Katrin Hoffmann1 3 Abstract Background The impact of hepatic resection for liver metastases LM on the survival of pediatric patients with Wilms tumor WT is unclear. So far there is a lack of studies investigating the best suited treatment for patients with WTLM and the role of liver resection has rarely been investigated. Thus the development of evidence-based guide lines concerning indications of liver resection for WTLM remains difficult. Aim To investigate the role of surgery in the therapy of WTLM. All available data on liver resections and subgroup outcomes of patients with WTLM are analyzed. Main research question is whether liver resection improves survival rates of patients with WTLM compared to non-surgical treatment. Methods A systematic literature search of MEDLINE Web of Science and Central provided the basis for this PRISMA- compliant systematic review. For the main analysis I all studies reporting on surgical treatment of pediatric WTLM were included. To provide a representative overview of the general outcome of WTLM patients in analysis II all studies with cohorts of at least five WTLM patients regardless of the kind of treatment were reviewed and analyzed. A Multi ple meta-regression model was applied to investigate the impact liver resection on overall survival. Results 14 studies with reports of liver resection for WTLM were found Analysis I . They included a total of 212 patients with WTLM of which 93 underwent a liver resection. Most studies had a high risk of bias and the quality was heterogenous. For the analysis II eight studies with subgroups of at least five WTLM patients were found. The weighted mean overall survival OS of WTLM patients across the studies was 55
