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The Management of Relapsed Wilms Tumor

1995; Elsevier BV; Volume: 9; Issue: 6 Linguagem: Inglês

10.1016/s0889-8588(18)30046-7

1558-1977

James S. Miser, Marie France Tournade,

Ethics and Legal Issues in Pediatric Healthcare

Wilms tumor is very responsive to therapy at relapse. The outcome in children who relapse is strongly related to specific prognostic factors; therefore, therapy should be tailored to the prognosis for each individual child. The most important prognostic factors associated with a better outcome are disease recurrence in the lungs (unilateral involvement is better than bilateral) or in the abdomen without prior irradiation, favorable histology, low initial stage of disease, and a recurrence more than one year after initial diagnosis. The important agents used to treat recurrent Wilms tumor are discussed. For high-risk relapsed patients, promising resuits are being achieved using high-dose therapy followed by autologous stem cell rescue.