Outcomes of Wilms' tumor in eastern China: 10 years of experience at a single center.

PURPOSE

Wilms' tumor (WT), or nephroblastoma, is the most common renal malignancy of childhood, and its outcome varies. We aimed to retrospectively review the clinical parameters and outcomes of WT cases treated at our medical center to identify factors associated with its prognosis.

METHODS

We retrospectively reviewed WT patients who had undergone surgery and other therapy in our hospital from May 1998 to May 2008. Demographic features, mode of presentation, stage of tumor, histopathologic results, and survival rates were evaluated.

RESULTS

Our study included 67 children with WT; 38 were males and 29 were females. The mean age at onset was 39 months. Eighteen cases were diagnosed as Stage I, 23 as Stage II, 20 as Stage III, and 6 as Stage IV. Nephroureterectomy was the initial treatment in 57 children. There were 46 (68.7%) cases of favorable histology and 21 (31.3%) cases of unfavorable (anaplastic) histology. The rates of four-year event-free survival and overall survival were 78.3% and 81%, respectively. The four-year overall survival rate for cases of favorable histology (85.8%) was higher than for those with unfavorable histology (71.4%; p =.028).

CONCLUSIONS

The outcomes of WT patients in our institution were little poorer than for those of the third National Wilms Tumor Study. Advanced clinical stage at presentation, unfavorable histology, tumor rupture, relapse, delay of radiotherapy due to ignorance, and premature ending of treatment were the important factors that impacted on the outcome of WT.