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Almost all children with Wilms tumor do well with the current treatment. Only about 10% of patients have features that are associated with a poorer prognosis and require more intensive therapy. In this section you can read about the different treatments for Wilms tumor, depending on the risk group assignment.

The Children's Oncology Group has established standard treatment recommendations for children with Wilms tumor who are treated in North America. The majority of children are treated with surgery and chemotherapy, and in some cases radiation. Because Wilms tumor is such a rare disease, the majority of young cancer patients enter into Phase III clinical trials, such as the one offered through the Children's Oncology Group.

The treatment depends on the risk group stratification, which is determined by:

• the appearance of Wilms tumor under the microscope
• the stage of the tumor
• molecular biology studies (in some cases)

The appearance of Wilms tumor under the microscope is first used to separate Wilms tumor into two mains groups. Clicking on one of these groups will allow you to read about your child's treatment according to his/his stage of tumor.

1. Favorable histology Wilms tumor
   • This type of Wilms tumor makes up about 90% of the cases. No anaplastic cells are seen under the microscope.
2. Anaplastic histology Wilms tumor
   • Focal anaplasia: Anaplastic changes are confined to a small region within the tumor.
   • Diffuse anaplasia: Anaplastic changes are present in multiple sites within the tumor or in tissue outside of the kidney.

Written and reviewed by: Susanne Ragg, MD, PhD; Deannie Lee, MD, PhD; Mary M Davis MD; James Hill, MD; Mercy Odueyungbo, B.S.; Ann Haddix, RN, MSN, CPNP; Jada Paine, MS; Julie Haydon, BS; Michelle Lucke, MPH; Elaine Skopelja, MALS, AHIP; Kellie Kaneshiro, AMLS, AHIP. Amber McMahon, B.S. Date last reviewed: August 2006.