Discussion
Anyone here been through this experience with a child? My daughters cousin was diagnosed on Friday, six years old & is in for tests. The immediate family are not coping very well, understandably and the reading up I've done suggests it's pretty treatable but I can't quite get my head round the staging.
As I understand it, the tumour can't be accurately classified and so a prognosis reached until after treatment. We know already that it will be chemo & the kidney removed. Any info gratefully received.
As I understand it, the tumour can't be accurately classified and so a prognosis reached until after treatment. We know already that it will be chemo & the kidney removed. Any info gratefully received.
Sorry to hear about the recent diagnosis in a friend of the family - no oncology diagnosis is good, but outlook in children is generally more favorable.
Wilm's (nephroblastoma) is the most common primary malignant renal runout in children. There are associated conditions that increase the risk but if the child is otherwise normal these will not be an issue. Some rare cases are familial.
Staging can be performed prior to histology, but what you are referring to seems to be the idea of risk-adapted therapy. By having a histological diagnosis the chemo can be tweaked to suit the tumour and so improve outcome.
Recent 10 year survival figures are as follows:
Stages I-V with favorable histology have 65-91% recurrence free survival and 78-96% overall survival. Anaplastic changes on histology whatever the stage comes with poorer overall outcome. (Figures from children's oncology group data: national Wilm's tumour study IV)
There are generally two schools of thought on the management - removal and then chemo, or pre-operative chemo then Removal. Each has the same outcome. Pre-op chemo can make surgery easier but early surgery can facilitate risk-adapted treatment.
Features of the tumour itself will effect prognosis eg weight, stage, age of pt. if the patient is less than 2 yrs and has a tumour weight less than 550g then it is very favorable. Chemo is used as the mainstay of treatment. Even with recurrence the chance of total cure is high so don't be down heartened if it doesn't all go immediately to plan. Most have a very favorable prognosis. Overall survival is near 90%.
I hope this helps answer your question.
Wilm's (nephroblastoma) is the most common primary malignant renal runout in children. There are associated conditions that increase the risk but if the child is otherwise normal these will not be an issue. Some rare cases are familial.
Staging can be performed prior to histology, but what you are referring to seems to be the idea of risk-adapted therapy. By having a histological diagnosis the chemo can be tweaked to suit the tumour and so improve outcome.
Recent 10 year survival figures are as follows:
Stages I-V with favorable histology have 65-91% recurrence free survival and 78-96% overall survival. Anaplastic changes on histology whatever the stage comes with poorer overall outcome. (Figures from children's oncology group data: national Wilm's tumour study IV)
There are generally two schools of thought on the management - removal and then chemo, or pre-operative chemo then Removal. Each has the same outcome. Pre-op chemo can make surgery easier but early surgery can facilitate risk-adapted treatment.
Features of the tumour itself will effect prognosis eg weight, stage, age of pt. if the patient is less than 2 yrs and has a tumour weight less than 550g then it is very favorable. Chemo is used as the mainstay of treatment. Even with recurrence the chance of total cure is high so don't be down heartened if it doesn't all go immediately to plan. Most have a very favorable prognosis. Overall survival is near 90%.
I hope this helps answer your question.
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