Treatments for stage 1 Wilms tumour

The following are treatment options for stage 1 Wilms tumour. The healthcare team will suggest treatments based on your child’s needs and work with you to develop a treatment plan.

The healthcare team also considers the type of Wilms tumour when they plan treatments. Treatment for stage 1 Wilms tumour with favourable histology involves surgery to remove the tumour, which for some children is followed by chemotherapy. Treatment for stage 1 Wilms tumour with anaplastic (unfavourable) histology involves surgery to remove the tumour, followed by radiation therapy to the site of the tumour and chemotherapy.

Surgery

Surgery is the main treatment for stage 1 Wilms tumour. The most common surgery used is a radical nephrectomy (removal of the kidney) with lymph node removal. Surgery may be followed by other treatments depending on the histology of the tumour.

Children under 2 who have small tumours with a favourable histology may only have surgery. This has proven to be an effective strategy for this group of patients. These children need to be watched closely because the risk of the cancer coming back (recurring) is slightly higher without chemotherapy. It is important to discuss the pros and cons of this strategy with the doctor to decide what is best for your child and family.

Find out more about surgery.

Chemotherapy

Chemotherapy is usually given for stage 1 Wilms tumour when the tumour is large or the child is over the age of 2. For tumours with a favourable histology, chemotherapy is given after surgery. For tumours with an anaplastic histology, it is given after surgery along with radiation therapy.

Favourable histology tumours are treated with vincristine (Oncovin) and dactinomycin (Cosmegen, actinomycin-D). Chemotherapy is given for 19 weeks after surgery.

Favourable histology tumours with some chromosome changes may be treated with vincristine, dactinomycin and doxorubicin (Adriamycin) for 25 weeks.

Anaplastic histology tumours are treated with vincristine, doxorubicin and dactinomycin. These drugs are given for 25 weeks after surgery and radiation therapy.

Radiation therapy

Radiation therapy is given as part of treatment for anaplastic stage 1 Wilms tumour. Radiation therapy is given to the original site of the tumour after surgery, along with chemotherapy.

Clinical trials

Children with cancer may be treated in a clinical trial. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Expert review and references

  • American Cancer Society. Treating Wilms Tumour. 2016.
  • American Society of Clinical Oncology. Wilms Tumor - Childhood. 2016.
  • Drigan, R. and Androkites, A. . Wilms Tumor. Baggott, C. R., Kelly, K. P., Fochtman, D. et al. Nursing Care of Children and Adolescents with Cancer. 3rd ed. Philadelphia, PA: W. B. Saunders Company; 2002: 26: pp.568-574.
  • Duffey-Lind, E . Tumours of the kidney. Kline, N. E. (Ed.). Essentials of Pediatric Oncology Nursing: A Core Curriculum. 2nd ed. Association of Pediatric Oncology Nurses; 2004: 2.10:46-49.
  • Fernandez CV, Geller JI, Ehrlich PF et al . Renal Tumors. Pizzo PA & Poplack DG (eds.). Principles and Practice of Pediatric Oncology. 7th ed. Philadelphia: Wolters Kluwer; 2016: 29:753-768.
  • Wilms tumor. Janes-Hodder, H. & Keene, N. Childhood Cancer - A Parent's Guide to Solid Tumor Cancers. 2nd ed. O'Reilly; 2002: 9:137-149.
  • Macmillan Cancer Support. Wilms Tumour in Children. 2016.
  • National Cancer Institute. Wilms Tumor and Other Childhood Kidney Tumors Treatment (PDQ®) Patient Version. 2017.
  • National Cancer Institute. Wilms Tumor and Other Childhood Kidney Tumors Treatment (PDQ®) Health Professional Version. 2017.
  • Wilms tumor in children. National Childhood Cancer Foundation & Children's Oncology Group. CureSearch. Bethesda, MD: 2011.
  • Paulino, Arnold C. Medscape Reference: Wilms Tumor Treatment and Management. 2016: http://emedicine.medscape.com/.
  • Wilms' Tumor: The Basics. University of Pennsylvania. OncoLink. Reviewed ed. University of Pennsylvania; 2008.