Results from treatment of Wilm's tumor at Roswell Park 1927–1968

Abstract

Abstract A retrospective study of forty‐two of forty‐nine cases of Wilm's tumors treated at the Roswell Park Memorial Institute over the past forty years is presented. Abdominal palpation to date remains the most important finding. Since over 20% demonstrated nonfunction on intravenous pyelogram, preoperative diagnosis and differentiation from neuroblastoma are therefore not always certain. Artereography may be helpful in selected instances. Metastases were present in 29 cases at the time they were first seen at the Institute. Modes of therapy were; nephrectomy, 41 cases; plus radiation therapy, 40 cases; and plus chemotherapy, 27 cases. The relationship of age of onset, stage of tumor, presence of metastasis, mode of therapy, and length of survival is presented. Current therapy includes nephrectomy, radiation therapy, and chemotherapy with actinomycin D or vincristine, or both, and monthly follow‐up is advised. Further correlations of histopathological features with survival are made in 16 cases. The absence of undifferentiated sarcomatous components seems to be the best prognostic feature.