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Prognosis

Authoring team

The prognosis for a Wilms' tumour patient depends on stage:

  • Stage 1 - 80% survival at 5 years
  • Stage 3 - 50% survival at 5 years

The prognosis has improved dramatically in recent years such that 66% of those with stage 4 disease and unfavourable histology survive relapse-free for at least 2 years.

Overall survival of patients with bilateral tumours is 64% at 10 years.

Ten percent of tumours have an unfavourable histology, and it is these that account for 50% of the mortality.

Notes:

  • Wilms' tumor metastasis occurs in children and adults in 10% and 29% of the cases, respectively
    • nephroblastoma in adults is considered worse than in children
      • Stages III and IV are present in 50% of adults and 30% of children
      • a higher advancement stage and common metastatic events are the reasons for worse treatment outcomes in adults compared to children
    • prognosis depends on the primary advancement stage, the histopathology, time since the first remission, type of therapy, and the recurrence location
      • in patients with recurrence three-year survival is about 30%, especially in the presence of poor prognostic factors such as advanced stage greater than I, abdominal relapse at the site of previous radiotherapy, early recurrence (<12 months)

Reference:

  • Fawcett, D.. Renal Tumours. Surgery 1994;12(9):193-7.
  • Kumar A, Lal B, Singh M, Kapur B. Adult Wilms' tumour: raport of a case and review of the literature. Jpn J Surg. 1990;20:585-589.
  • Grundy P, Telzerow P, Moksness J, Moksness J, Breslow N. Clinicopathologic correlates of loss of heterozygosity in Wilms' tumor: a preliminary analysis. Med Pediatr Oncol. 1996;27:429-433

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