Surgery only for the treatment of patients with stage I (Cassady) Wilms' tumor.
A prospective pilot study was undertaken to examine the outcome of patients with Stage I (Cassady) Wilms' tumor treated with nephrectomy only. Eight consecutive patients fulfilling the criteria for Stage I (Cassady) Wilms' tumor (age less than 2 years with unilateral, nonmetastatic, favorable histopathologic type, and tumor weight less than 550 g) underwent nephrectomy with no further therapy. All eight patients were alive and free of disease with a mean follow-up period of 5 years. There was one tumor recurrence that involved a metachronously occurring bilateral tumor. Overall survival (100%) and event-free survival (88%) were comparable with clinical trials in which patients received adjuvant therapy. Patients with Stage I (Cassady) Wilms' tumor can be successfully treated with nephrectomy alone, thereby eliminating the toxicity of adjuvant therapy.
Larsen
E
E
Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02115.
Perez-Atayde
A
A
Green
D M
DM
Retik
A
A
Clavell
L A
LA
Sallan
S E
SE
D005260:Female; D006801:Humans; D007223:Infant; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000601:surgery; D009392:Nephrectomy; D010865:Pilot Projects; D011446:Prospective Studies; D009396:Wilms Tumor / Q000473:pathology / Q000601:surgery*