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Gleason JM, Lorenzo AJ, Bowlin PR, et al. Innovations in the management of Wilms' tumor. Ther Adv Urol. 2014;6(4):165-76doi: 10.1177/1756287214528023.
Gleason, J. M., Lorenzo, A. J., Bowlin, P. R., & Koyle, M. A. (2014). Innovations in the management of Wilms' tumor. Therapeutic advances in urology, 6(4), 165-76. https://doi.org/10.1177/1756287214528023
Gleason, Joseph M, et al. "Innovations in the management of Wilms' tumor." Therapeutic advances in urology vol. 6,4 (2014): 165-76. doi: https://doi.org/10.1177/1756287214528023
Gleason JM, Lorenzo AJ, Bowlin PR, Koyle MA. Innovations in the management of Wilms' tumor. Ther Adv Urol. 2014 Aug;6(4):165-76. doi: 10.1177/1756287214528023. PMID: 25083165; PMCID: PMC4054506.
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Ther Adv Urol. 2014 Aug;6(4):165-76. doi: 10.1177/1756287214528023.

Innovations in the management of Wilms' tumor.

Therapeutic advances in urology

Joseph M Gleason, Armando J Lorenzo, Paul R Bowlin, Martin A Koyle

Affiliations

  1. Division of Paediatric Urology, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  2. Division of Paediatric Urology, The Hospital for Sick Children, Department of Surgery, University of Toronto, 555 University Avenue, Toronto, ON, Canada M5G 1X8.

PMID: 25083165 PMCID: PMC4054506 DOI: 10.1177/1756287214528023

Abstract

Advances in the management of Wilms' tumor have been dramatic over the past half century, not in small part due to the institution of multimodal therapy and the formation of collaborative study groups. While different opinions exist in the management of Wilms' tumors depending on where one lives and practices, survival rates have surpassed 90% across the board in Western societies. With more children surviving into adulthood, the concerns about morbidity have reached the forefront and now represent as much a consideration as oncologic outcomes these days. Innovations in treatment are on the horizon in the form of potential tumor markers, molecular biological means of testing for chemotherapeutic responsiveness, and advances in the delivery of chemotherapy for recurrent or recalcitrant tumors. Other technological innovations are being applied to childhood renal tumors, such as minimally invasive and nephron-sparing approaches. Risk stratification also allows for children to forego potentially unnecessary treatments and their associated morbidities. Wilms' tumor stands as a great example of the gains that can be made through protocol-driven therapy with strenuous outcomes analyses. These gains continue to spark interest in minimization of morbidity, while avoiding any compromise in oncologic efficacy. While excitement and innovation are important in the advancement of treatment delivery, we must continue to temper this enthusiasm and carefully evaluate options in order to continue to provide the highest standard of care in the management of this now highly curable disease.

Keywords: Wilms’ tumor; innovations; minimally invasive; nephron sparing

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