Treatments for stage 3 Wilms tumour

The following are treatment options for stage 3 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 3 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. Chemotherapy and radiation therapy are usually given after surgery.

Sometimes stage 3 Wilms tumours canʼt be completely removed with surgery because of their size or location. If a tumour can’t be removed safely because it is too large or has grown into nearby tissues or blood vessels, a small tissue sample may be removed for biopsy to check the histology of the tumour. Chemotherapy will be given to try to shrink the tumour. If chemotherapy shrinks the tumour enough that it can be removed, surgery is done and then more chemotherapy is given along with radiation therapy.

Find out more about surgery for Wilms tumour.

Radiation therapy uses high-energy rays or particles to destroy cancer cells.

After a stage 3 Wilms tumour has been removed with surgery, radiation therapy is given to the area where the kidney was removed or to the entire abdomen. Radiation therapy starts 10 to 14 days after surgery. Chemotherapy is given with radiation therapy.

Find out more about radiation therapy for Wilms tumour.

Chemotherapy uses drugs to destroy cancer cells.

After a stage 3 Wilms tumour has been removed with surgery, chemotherapy is given with radiation therapy.

If the tumour can’t be removed safely with surgery, chemotherapy may be given before surgery to shrink the tumour and then given again after surgery.

The chemotherapy drugs used depend on the type of tumour.

Favourable histology tumours are treated with vincristine, doxorubicin and dactinomycin. Chemotherapy is given for 27 weeks (9 cycles) after surgery.

Favourable histology tumours with chromosome changes are treated with vincristine, doxorubicin, dactinomycin, cyclophosphamide and etoposide for about 33 weeks (11 cycles) after surgery.

Focal anaplastic tumours are treated with vincristine, doxorubicin and dactinomycin for 27 weeks (9 cycles) after surgery.

Diffuse anaplastic tumours are treated with vincristine, doxorubicin, etoposide, cyclophosphamide and carboplatin for 42 weeks (14 cycles) after surgery.

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

Find out more about chemotherapy 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.