Management of Wilms tumor: current standard of care

@article{Sonn2008ManagementOW,
  title={Management of Wilms tumor: current standard of care},
  author={Geoffrey A. Sonn and Linda MD Shortliffe},
  journal={Nature Clinical Practice Urology},
  year={2008},
  volume={5},
  pages={551-560}
}
Wilms tumor is the most common renal malignancy in children. In the 1930s, overall survival for children with Wilms tumor was approximately 30%. Use of multidisciplinary therapy, guided by results from multi-institutional, randomized trials, has substantially improved overall survival to about 90%. Management of Wilms tumor differs substantially between Europe and the US. In Europe, the International Society of Pediatric Oncology protocols call for management of patients with presumptive Wilms… 

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References

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TLDR
The goal of current clinical trials is to reduce therapy for children with low-risk tumors, thereby avoiding acute and long-term toxicities, and to augment therapy for patients with high-risk Wilms' tumor, including those with bilateral, anaplastic, and recurrent favorable histology tumors.

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TLDR
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The treatment of Wilms' tumor. Results of the national Wilms' tumor study

The National Wilms' Tumor Study, initiated in 1969, tested competing treatment strategems for patients with tumors ranging from Group (Gp) I (tumors confined to the kidney and totally removed) to Gp

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TLDR
Preoperative chemotherapy is as good as preoperative radiotherapy in terms of prevention of tumor rupture, and 43% of an unselected population of patients with Wilms' tumor could be treated without any radiotherapy when chemotherapy had been given preoperatively.

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TLDR
This study has demonstrated that surgical rupture of the tumor must be prevented by the surgeon, because spills produce an increased risk of local relapse.
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