What is a stage V Wilms tumor?

Updated: Feb 01, 2019
  • Author: Tunc Ozan, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Answer

Wilms tumor is designated as stage V if cancer cells are found in both kidneys when the disease is first diagnosed. After bilateral renal biopsies and staging of each kidney, treatment of stage V Wilms tumor varies by stage, as follows:

  • Stage I or II disease in both kidneys: Vincristine and dactinomycin, preoperatively and for 18 weeks postoperatively

  • Stage III or IV disease in both kidneys: Vincristine, dactinomycin, and doxorubicin, preoperatively and for 24 weeks postoperatively

  • Stage III or IV disease in both kidneys with favorable histology: Vincristine, doxorubicin, cyclophosphamide, and etoposide preoperatively and for 24 weeks postoperatively

  • Stage III or IV disease in both kidneys with focal and/or diffuse anaplasia: Vincristine, doxorubicin, cyclophosphamide, and etoposide preoperatively and for 24 weeks postoperatively, followed by second-look surgery and possibly more chemotherapy and/or radiotherapy [22, 23, 24]

Bilateral, high-stage tumors with unfavorable histology are associated with a poor prognosis in spite of multimodal therapy.


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