Wilms' Tumor: Management and Prognosis

Although the operation and chemotherapy of children with Wilms' tumor is best carried out in a children's cancer center, the family pediatrician will want to advise parents as to what will be done and the prognosis. With no evidence of metastases and therapy consisting of postoperative irradiation of the renal bed and combined therapy with two agents (dactinomycin and vincristine) cure rates are now 85% to 90%. When metastases do occur, lungs are the most common site. There is an increased occurrence of Wilms' tumor in children with hemihypertrophy, aniridia, and horseshoe kidneys.