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Wilms' tumour: trials and tribulation.

D C Gough1

  • 1Royal Manchester Children's Hospital, Pendlebury, UK.

Progress in Pediatric Surgery
|January 1, 1989
PubMed
Summary

Multimodal treatment, including surgery, radiotherapy, and chemotherapy, is key for Wilms tumor. Chemotherapy significantly improves survival by targeting micrometastases, though it requires careful management due to toxicity.

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Area of Science:

  • Pediatric Oncology
  • Surgical Oncology
  • Medical Oncology

Background:

  • Wilms tumor treatment relies on a multimodal approach.
  • Surgery is the primary treatment modality, offering a cure in 25% of cases when used alone.
  • Surgical risks include venacaval tumor embolization, and inoperable cases have reduced survival rates.

Purpose of the Study:

  • To review the current multimodal treatment strategies for Wilms tumor.
  • To highlight the roles and advancements in surgery, radiotherapy, and chemotherapy.
  • To discuss factors influencing patient survival and treatment outcomes.

Main Methods:

  • Review of current treatment protocols for Wilms tumor.
  • Analysis of surgical outcomes, including mortality and complications.
  • Evaluation of the impact of radiotherapy and chemotherapy on survival rates.

Main Results:

  • Surgery is central to Wilms tumor management, with reduced mortality rates.
  • Histological characteristics and disease stage are critical survival determinants.
  • Chemotherapy has improved survival by 25%, particularly in controlling micrometastases, but carries toxicity risks.

Conclusions:

  • Multimodal therapy, integrating surgery, radiotherapy, and chemotherapy, optimizes Wilms tumor treatment.
  • Chemotherapy plays a vital role in enhancing survival by managing micrometastases.
  • Careful handling and modification of chemotherapy are essential due to its toxicity.

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