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59 - Wilms' tumor
- from Part VI - Oncology
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- By Michael L. Ritchey, Department of Surgery and Pediatrics, Division of Urology, University of Texas – Houston Medical School, USA, Nadeem N. Dhanani, Department of Urology, University of Texas – Houston Medical School, USA, Patrick G. Duffy, Department of Paediatric Urology, Great Ormond Street Hospital, London, UK, Gill A. Levitt, Department of Paediatric Urology, Great Ormond Street Hospital, London, UK, Anthony J. Michalski, Department of Paediatric Urology, Great Ormond Street Hospital, London, UK
- Edited by Mark D. Stringer, Keith T. Oldham, Pierre D. E. Mouriquand
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- Book:
- Pediatric Surgery and Urology
- Published online:
- 08 January 2010
- Print publication:
- 09 November 2006, pp 759-781
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- Chapter
- Export citation
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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.