Management Of Wilms Tumor Research Articles

Pediatric Articles

We report a case of tumor implantation along the needle tract after percutaneous biopsy of Wilms tumor. This is a rare but important complication in the management of Wilms tumor.

Pediatric renal masses

Imaging plays a significant role in the management of Wilms tumor. Appropriate imaging continually must undergo refinement related to improvements in therapy and imaging modalities. We must recognize the need to demonstrate effectiveness in all phases of patient management and address the contentious issue of maximizing yield and minimizing cost.

Vincristine, dactinomycin, and cyclophosphamide (VAC) chemotherapy for recurrent metastatic Wilms tumor in previously treated children

WILMS TUMOR CONSTITUTES the second most common solid tumor in the pediatric age group; about 450 cases of this malignancy are diagnosed annually in the United States. 1 The use of multimodal therapy in the management of Wilms tumor has become increasingly successful. Although survival for Wilms tumor is estimated to be in excess of 70%, ~ a the prognosis remains poor for patients who develop bilateral pulmonary or liver metastasis after initial therapy2- Most newly diagnosed children with Wilms tumor are presently treated according to the National Wilms Tumor Study. However, subsequent treatment of patients who fail on the national study protocol has not been uniform, and little information is available on the therapeutic response of patients with Wilms tumor who develop metastases. We are reporting the results obtained using vincristine, dactinomycin, and cyclophosphamide (VAC chemotherapy) in a group of previously treated patients with recurrent metastatic Wilms tumor at Childrens Hospital of Los Angeles. MATERIAL AND METHODS The characteristics of the ten patients treated with VAC chemotherapy are given in the Table. The median age at the time of diagnosis for this group of patients was 4 years, with seven patients older than 2 years. Histopathology of the tumor was reported as favorable in nine patients; one patient had the sarcomatous variant by the criteria of Beckwith and Palmer? Further classification of the favorable histology group demonstrated the tumor to be well differentiated in three patients, with tubular and/or glomeruloid structures easily recognized; three were clas

Radiation therapy in management of Wilms's tumor.

The authors analyzed treatment results in 71 cases of Wilms's tumor. The abdominal control rate was higher in 42 patients receiving postoperative radiotherapy (85.5%) than in 6 patients not receiving such therapy (1/6). In patients treated by nephrectomy and postoperative radiation, the addition of chemotherapy improved survival (78.2 VS. 30%). Pulmonary metastasis did not necessarily denote a hopeless situation since a significant number of patients could be salvaged by concurrent radiotherapy and chemotherapy; higher control rates were achieved with total than with less-than-total thoracic irradiation. Relatively low-dose irradiation appeared sufficient in both abdominal and thoracic radiotherapy if chemotherapy was given concurrently.