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59 - Wilms' tumor

from Part VI - Oncology

Published online by Cambridge University Press:  08 January 2010

By
Michael L. Ritchey ,
Nadeem N. Dhanani ,
Patrick G. Duffy ,
Gill A. Levitt  and
Anthony J. Michalski
Edited by
Mark D. Stringer ,
Keith T. Oldham  and
Pierre D. E. Mouriquand
Michael L. Ritchey
Affiliation:
Department of Surgery and Pediatrics, Division of Urology, University of Texas – Houston Medical School, USA
Nadeem N. Dhanani
Affiliation:
Department of Urology, University of Texas – Houston Medical School, USA
Patrick G. Duffy
Affiliation:
Department of Paediatric Urology, Great Ormond Street Hospital, London, UK
Gill A. Levitt
Affiliation:
Department of Paediatric Urology, Great Ormond Street Hospital, London, UK
Anthony J. Michalski
Affiliation:
Department of Paediatric Urology, Great Ormond Street Hospital, London, UK
Mark D. Stringer
Affiliation:
University of Otago, New Zealand
Keith T. Oldham
Affiliation:
Children's Hospital of Wisconsin
Pierre D. E. Mouriquand
Affiliation:
Debrousse Hospital, Lyon
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Summary

Wilms' tumor therapy

Prior to the modern era of cancer treatment, the only opportunity for cure of Wilms' tumor was complete surgical excision. Wilms' tumor was one of the first pediatric malignancies found to be responsive to systemic chemotherapy. Since the initial report by Farber, there has been a dramatic improvement in survival of children with this tumor. Many of these advances have occurred as a result of collaborative efforts of large pediatric cooperative cancer groups, such as the National Wilms Tumor Study Group (NWTSG) and the International Society of Pediatric Oncology (SIOP), which have been able to enroll large numbers of patients treated in a standardized manner since 1969. Now that more than 90% of children with Wilms' tumor can expect cure, these groups are focusing their attention to reducing the intensity of therapy in order to minimize treatment-related toxicity that may adversely affect long-term survival and quality of life. Damage to normal organs and tissues occurs and the effects may not become apparent for many years after treatment.

Tracking the late effects of Wilms' tumor treatment has been an integral part of the NWTSG for many years. Long-term toxicities of treatment are studied in a systematic way among uniform populations of children treated with similar therapies. This has helped to define the long-term adverse effects of treatment in patients alive 5 years or longer after the diagnosis of Wilms' tumor.

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Type
Chapter
Information
Pediatric Surgery and Urology
Long-Term Outcomes
 , pp. 759 - 781
Publisher: Cambridge University Press
Print publication year: 2006

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