Wilms' tumor—a clinical study of eighty-one patients

Eighty-one patients were treated for Wilm's tumor at the Cincinnati Children's Hospital Medical Center from 1950 to 1970. Significant factors in diagnosis included generalized symptoms, hematuria, a palpable mass, and an abnormal intravenous urogram. Survival was affected by anatomical stage of disease which appears to be inversely correlated with age at presentation. Improved survival was obtained with transabdominal nephrectomy and para-aortic node dissection, a single course of postoperative actinomycin D, and postoperative radiation therapy. The lungs were the site of first metastasis in 29 of the 37 patients who developed metastases. Twenty-eight percent of these patients treated adequately survived. The survival rate for this entire series “Life Table Method” was 66% at 2 years, 60% at 5 years, and 58% at 10 and 20 years after diagnosis. The survival rates for the individual stages were Stage I–85%, Stage II–73%, Stage III–32%, Stage IV–37%, and Stage V–47% at 5 years after diagnosis.