Home | About Us | Current Issue | Ahead of print | Archives | Search | Instructions | Subscription | Feedback | Editorial Board | e-Alerts | Login 
Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
 Users Online:62 
  Print this page Email this page   Small font sizeDefault font sizeIncrease font size
 REVIEW ARTICLES
Year : 2005  |  Volume : 10  |  Issue : 4  |  Page : 217-228

Saga of Wilms' tumor: Lessons learnt from the past


1 Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
2 Yorkhill Childrens Hospital, Glasgow, United Kingdom

Correspondence Address:
Devendra K Gupta
Department of Pediatric Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110 029
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9261.19271

Rights and Permissions

Wilms' tumor (WT) represents 6% of childhood cancers. Recent advances in molecular biology have significant implications for the clinical management. A dramatic improvement in overall cure has resulted from the adoption of multimodality treatment during the past few decades. National Wilms' Tumor Study (NWTS), and the Sociιtι Internationale d'Oncologie Pιdiatrique (SIOP) have laid down the guidelines for standardized treatment of WT, though differing in the diagnostic and therapeutic approach. Both these groups currently aim at intensifying treatment for patients with poor prognosticators while appropriating the therapy to reduce long-term complications for those with favorable prognostic features. Challenges faced in developing nations include poverty, malnutrition, ignorance, and presentation in advanced stages coupled with limited facilities that are necessary for total management of these cases. In this article, we have discussed our approach to deal with patients with nephroblastoma, reviewed the literature on the current management strategies and the long-term outcome. Most countries have adopted the NWTS protocols, while others especially in Europe, South America and some Asian countries follow the SIOP regimen. Both have their advantages and weaknesses and maynot necessarily be suitable to the setup in developing countries. We have discussed the controversial issues in the management of WT including the timing of biopsy, type of biopsy, investigative approach, role of chemotherapy / radiotherapy, management of bilateral Wilms' tumor and parenchymal sparing renal surgery. Despite deviating from NWTS at various points, the overall results have remained satisfactory. Thus, developing countries might adopt their own protocols depending on the prevalent situations and facilities available to them to treat such patients.






[FULL TEXT] [PDF]*


        
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed16647    
    Printed237    
    Emailed8    
    PDF Downloaded470    
    Comments [Add]    
    Cited by others 5    

Recommend this journal

 


Contact us | Sitemap | Advertise | What's New | Copyright and Disclaimer 

 © 2005 - Journal of Indian Association of Pediatric Surgeons | Published by Wolters Kluwer - Medknow 

Online since 1st May '05