title: Management of metastatic Wilms tumor: an eleven year experience.
abstract: During the last 11 years, 101 patients of Wilms tumor were seen. Of these, 13 patients had metastatic disease at onset while 24 patients presented with relapse at a latter date. Seven patients have been cured, all had favourable histology. The risk factors associated with relapse were found to be unfavourable histology, lymph node involvement, age more than 6 years, diffuse spill, capsular and vascular invasion, and aneuploidy. Of the 18 patients who had relapsed, 14 were found to be aneuploid. Judicious use of various therapeutic options like radiotherapy to metastatic sites, second look surgery, resection of pulmonary metastasis and use of cis-platinum, VP-16 and Ifosfamide as "alternative chemotherapy protocols" were used to achieve cure in these advance cases.
authors.affiliation: Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: D
authors.initials: D
authors.lastname: Misra
authors.forename: D K
authors.initials: DK
authors.lastname: Gupta
authors.forename: D K
authors.initials: DK
authors.lastname: Mitra
authors.forename: V
authors.initials: V
authors.lastname: Bhatnagar
authors.forename: M
authors.initials: M
authors.lastname: Bajpai
authors.forename: M
authors.initials: M
authors.lastname: Mathur
authors.forename: M
authors.initials: M
authors.lastname: Rohatgi
mesh_terms: D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009362:Neoplasm Metastasis; D012189:Retrospective Studies; D009396:Wilms Tumor / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*