Treatments for stage 2 Wilms tumour

The following are treatment options for stage 2 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 2 Wilms tumour with favourable histology involves surgery to remove the cancer, followed by chemotherapy. Treatment for stage 2 Wilms tumour with anaplastic (unfavourable) histology involves surgery to remove the cancer, followed by radiation therapy to the abdomen and chemotherapy.

Surgery

Surgery is the main treatment for stage 2 Wilms tumour. It is followed by radiation therapy or chemotherapy or both, depending on tumour histology. The most common surgery used is a radical nephrectomy (removal of the kidney) with lymph node removal.

Find out more about surgery.

Chemotherapy

Chemotherapy is given after surgery for stage 2 Wilms tumour. For tumours with anaplastic histology, chemotherapy is given after radiation therapy to the abdomen. The type of chemotherapy most commonly used is based on the type of tumour.

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.

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

Diffuse anaplastic tumours are treated with vincristine, doxorubicin, etoposide (Vepesid, VP-16), cyclophosphamide (Procytox) and carboplatin (Paraplatin, Paraplatin AQ) for 25 weeks.

When cyclophosphamide is used, mesna (Uromitexan) may also be given. Mesna helps protect the bladder from irritation from cyclophosphamide.

Radiation therapy

Radiation therapy to the abdomen is given as part of treatment for anaplastic stage 2 Wilms tumour. It is given 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.