Abstract

Wilms tumour is a common malignant renal tumour in children, responsible for 7% of all paediatric cancers. Prognosis and treatment depend upon the stage and histology of the tumour. Other prognostic factors such as age at diagnosis, tumour volume, histological response to therapy and genetic anomalies are being evaluated. The aim of the paper is to assess the prognostic factors in patients treated with Wilms tumour at the Paediatric Clinic from Targu-Mures, Romania. Imagistic, laboratory and histological data were assessed in 9 patients with Wilms tumour. The 9 patients aged 8 months- 10 years had Wilms tumour stage I (n=3), stage II (n=2) and stage III (n=4). Histology was performed in 8 cases after 4–6 weeks of neoadjuvant chemotherapy, and in one patient after first-line surgery. Tumor-spill occurred during first-line surgery. Except one patient, only 0–4 lymph nodes were removed during surgery. High-risk blastemal type histology appeared in 2 patients, intermediate-risk histology in 7 patients. Tumour reduction after neoadjuvant chemotherapy was higher in intermedier risk-group. Chemosensitivity of the tumour correlated better with histological risk-group than stage, tumor-volume or serum lactat-dehydrogenase (LDH) levels. Accidental prenatal exposition to anticonceptionals appeared in one 8-month-old infant. One patient with focal anaplasia histology died of progressive disease and metastases. Conclusions: Building up teams with oncological surgeons, pathologists, radiologists, paediatric oncologists, and radiotherapists may offer a better care for Wilms tumour patients.