Treatments for stage 1 Wilms tumour

The following are treatment options for stage 1 Wilms tumour. The healthcare team will suggest treatments based on the type of Wilms tumour (whether the tumour has a favourable or anaplastic histology) and your childʼs needs. They will work with you to develop a treatment plan.

Surgery is the main treatment for stage 1 Wilms tumour. The most common surgery used is a radical nephrectomy. A radical nephrectomy removes the whole kidney along with nearby structures. Lymph nodes near the kidney are also removed. Depending on the histology of the tumour, chemotherapy may be given alone or with radiation therapy after surgery.

Children under 2 years old who have small tumours with a favourable histology may only have surgery. Close follow-up is important because the risk of the cancer coming back (recurring) is slightly higher without chemotherapy. Talk to the healthcare team about the pros and cons of this treatment plan to decide what is best for your child and family.

Find out more about surgery for Wilms tumour.

Chemotherapy uses drugs to destroy cancer cells. Chemotherapy is usually given for stage 1 Wilms tumour when the tumour is large, has certain chromosome changes 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, chemotherapy is given after surgery along with radiation therapy. The chemotherapy drugs used depend on the type of tumour.

Favourable histology tumours are treated with vincristine and dactinomycin. Chemotherapy is given for about 21 weeks (7 cycles) after surgery.

Favourable histology tumours with chromosome changes may be treated with vincristine, dactinomycin and doxorubicin for 27 weeks (9 cycles) after surgery.

Focal anaplastic histology tumours are treated with vincristine and dactinomycin for 21 weeks (7 cycles) after surgery.

Diffuse anaplastic histology tumours are treated with vincristine, doxorubicin and dactinomycin. These drugs are given for 27 weeks (9 cycles) after surgery.

Find out more about chemotherapy for Wilms tumour.

Radiation therapy uses high-energy rays or particles to destroy cancer cells. Radiation therapy is used to treat stage 1 focal and diffuse anaplastic tumours after surgery. The rays are directed to the area where the kidney was removed with surgery or to the entire abdomen. Radiation therapy is given at the same time as chemotherapy.

Find out more about radiation therapy for Wilms tumour.

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.