Current Therapy for Wilms’ Tumor

Abstract

Abstract Learning Objectives After completing this course, the reader will be able to: Describe the clinical and biological prognostic factors for Wilms’ tumor.Discuss the different treatment strategies and staging systems adopted in North America and Europe.Explain the challenges and treatment approaches for anaplastic, bilateral, and recurrent Wilms’ tumor. Access and take the CME test online and receive 1 AMA PRA category 1 credit at CME.TheOncologist.com Wilms’ tumor was the first solid malignancy in which the value of adjuvant chemotherapy was established. Multimodality treatment has resulted in a significant improvement in outcome from approximately 30% in the 1930s to more than 85% in the modern era. Although the National Wilms’ Tumor Study Group and the International Society of Pediatric Oncology differ philosophically regarding the merits of preoperative chemotherapy, outcomes of patients treated with either up-front nephrectomy or preoperative chemotherapy have been excellent. The goal of current clinical trials is to reduce therapy for children with low-risk tumors, thereby avoiding acute and long-term toxicities. At the same time, current clinical trials seek to augment therapy for patients with high-risk Wilms’ tumor, including those with bilateral, anaplastic, and recurrent favorable histology tumors.