[Diagnosis and therapy of Wilms' tumor based on a survey of 16 children with nephroblastoma].

On the second place in malignant diseases of children, after the leukemias, we could find the Wilms-Tumor. Of the 16 children we treated in the years from 1965 to 1977, 8 children died, 2 patients couldn't be any longer observed and 6 patients are still alive. 5 children of these have obtained now a relapse-free survival from 1 year and 2 months to 2 years and 7 months. We could see, that the prognosis depends only on the stage of the tumor and not on the age of patients. On 3 cases we will try to show, how difficult the diagnosis of the Wilms-Tumor is and how important it is, to treat resolutely pulmonary and liver metastases. As diagnostic methods were used i. v. P., the sonography and the selective renalangiography. Since 1976 our treatment consists of preoperative irradiation of tumors, nephrectomy, postoperative irradiation of tumor-bed and adjuvant chemotherapy (actinomycin D, vincristine and adriamycin). Pulmonary and liver metastases are a domain for chemotherapy, combined with irradiation (danger of pneumonitis and toxic hepatitis) and eventually a resection is necessary. Only the good cooperation of an oncologic team could achieve an improvement of the cure rate of this tumor, as we know from the American countries (survival 75%).