The diagnosis and treatment of Wilms' tumor-a review of 69 cases

Abstract

Objective To retrospectively review 10 years'experience in diagnosis and treatment of Wilm's tumor,and to determine the prognostic factors. Methods Sixty-nine patients with Wilms'tumor were enrolled in this study. Patient'gender,age at diagnosis,clinical symptoms,tumor stage,pathology and therapy were analyzed statistically. Kaplan-Meier survival analysis was applied to esti-mate the survival time of patients with different stage and pathological features. Results The average age at onset of tumor was (3.25±2.78)years old. Abdominal masses were the major signs. Of the 69 patients,there were 18 cases of stage Ⅰ,25 of stage Ⅱ,20 of stage Ⅲ and 6 of stage Ⅳ. The pa-tients were treated with multimodal therapy consisting of extirpative surgery,chemotherapy and limit-ed radiotherapy. The patients were followed up for 4 months to 123 months with a mean survival time of (41±30.9) months. The survival rates of each stage were 100% in stage Ⅰ,76% in stage Ⅱ,70% in stage Ⅲ,and 50% in stage Ⅳ. There was no difference of survival time among the stage Ⅰ,Ⅱ and Ⅲ patients. Compared with the stage Ⅰ,Ⅱ and Ⅲ patients,the survival time of the patients with stage Ⅳ tumor was significantly decreased (P= 0.04). The survival rates of the patients with fa-vorable histology (FH) Wilms'tumors was 86.9%,and decreased to 65.2% in the patients with unfa-vorable histology (UH) tumors. Significant difference of survival time between FH patients and UH patients was found using Kaplan-Meier survival analysis (P = 0.004). Conclusions Clinical stage and pathological features were the important prognostic factors of Wilms'tumor. Key words: Wilms tumor; Prognosis; Tissue typing