Wilms' Tumor: Experience of Regional Children’s Hospital in Serbia

Abstract

Wilms' tumor-nephroblastoma is the most common malignant tumor of the kidney in children. It belongs to disontogenetic tumors, developing in early embryogenesis. Typical age for diagnosis is between 1st and 3rd year of life but it can be found until 15th year. Wilms' tumor develops more often in children with other congenital anomalies. It is caused by mutations of Wilms' tumor suppressor gene WT1 (11p13) and WT2 (11p15). Clinically it presents most often with enlargement of abdomen and haematuria. Diagnosis is made by the ultrasonography and computerized tomography. Patients are treated according to tumor histology and stage. Aim of the study was to present the prevalence of Wilms tumor in regional childrens hospital and identify factors correlating to bad prognossis. The study was retrospective and presents the period of 16 years, from 1995 to 2010. It was conducted in the Center for Hematology and Oncology in the Institute for Children and Youth Health Care of Vojvodina-Novi Sad, Serbia. Prevalence of Wilms' tumor was 23 children in 16 years with higher incidence in years: 2003, 2005, 2009 and 2010. Children diagnosed in stage I and II had better 2 year disease free and overall survival than children in stage III and IV. Also when diagnosis was made in less than 1 month, 2 year disease free and overall survival was better than in group where the diagnosis was made in a period after 1 month. In management of Wilms' tumor there is still controversy whether the children should receive upfront chemotherapy versus primarily operation.