Durnov L A, Bukhny A F, Saltanov A I, Lebedev V I, Sotnikova E N
Vopr Onkol. 1982;28(5):109-15.
An evaluation of 388 cases of Wilms tumor within 13 years established a high proportion of advanced cases among children: stage II - 30.6; III - 35.4; IV - 27.6 and V (bilateral) - 6.4%. Main homeostatic indices remained unchanged until stages III-IV. Primary tumor and metastases can be detected by a complex of clinical, X-ray and radioisotope methods the effectiveness of which is determined by degree of tumor extension. Dissemination of tumor at different sites were detected by primary examination in 40.5% and at later stages in 15% of patients. Most metastases (96%) were detected within the first 12 months of therapy. They were significantly more frequent at stage III and their frequency was in correlation with the patient's age at the time of tumor detection. Out of 388 cases, 112 (28.9%) survived for more than 3 years, stage II - 57.1; stage III - 25.4 and stage IV - 4.6% included. 1.5 - 2 year-long courses of pre- and postoperative polychemotherapy proved to be effective, whereas in cases of stage III tumor they should be supplemented with irradiation of primary tumor, its bed, regional lymph collectors and metastases. These measures ensured a 3-year survival in 69.5% of stage II patients and in 32.3% of stage III patients.
对13年内388例肾母细胞瘤病例的评估显示，儿童晚期病例占比很高：Ⅱ期为30.6%；Ⅲ期为35.4%；Ⅳ期为27.6%；Ⅴ期（双侧）为6.4%。直到Ⅲ - Ⅳ期，主要的内稳态指标保持不变。原发肿瘤和转移灶可通过临床、X线和放射性同位素等综合方法检测，其有效性取决于肿瘤的扩展程度。40.5%的患者在初诊时发现不同部位有肿瘤播散，15%的患者在后期发现。大多数转移灶（96%）在治疗的前12个月内被检测到。它们在Ⅲ期明显更常见，且其发生频率与肿瘤发现时患者的年龄相关。在388例病例中，112例（28.9%）存活超过3年，其中Ⅱ期为57.1%；Ⅲ期为25.4%；Ⅳ期为4.6%。术前和术后为期1.5 - 2年的多药化疗疗程被证明是有效的，而对于Ⅲ期肿瘤患者，应辅以原发肿瘤、其瘤床、区域淋巴结和转移灶的放疗。这些措施确保了69.5%的Ⅱ期患者和32.3%的Ⅲ期患者存活3年。
