Premium
The changing management of Wilms' tumor over a 30‐year period 1949‐1978
Author(s) -
Clouse John W.,
Thomas Patrick R. M.,
Griffith Rogers C.,
Perez Carlos A.,
Vietti Teresa J.,
Fineberg Barbara
Publication year - 1985
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19850915)56:6<1484::aid-cncr2820560644>3.0.co;2-c
Subject(s) - medicine , wilms' tumor , stage (stratigraphy) , chemotherapy , subclinical infection , mallinckrodt , oncology , surgery , paleontology , family medicine , biology
Seventy‐four patients with histologically confirmed diagnoses of Wilms' tumor were treated between 1949 and 1978 at the Mallinckrodt Institute of Radiology and St. Louis Children's Hospital. The results have been divided into two eras of therapy, i.e. , before and after 1965, when chemotherapy became a major modality for Wilms' tumor therapy. Analysis at 5 years by era of therapy has shown similar disease‐free survival results for Stage I (“prechemotherapy” era 67% versus “chemotherapy” era 75%), whereas the Stage II (“prechemotherapy” era 33% versus “chemotherapy” era 100%) and Stage III (“prechemotherapy” era 0% versus “chemotherapy” era 70%) are significantly different ( P < 0.001). This suggests that chemotherapy has substituted for postoperative irradiation in Stage I patients; whereas in Stage II and III, improved survival occurs as a result of the eradication of subclinical metastatic disease. The patterns of failure by era of treatment are presented and the literature is discussed.