LL Yang, MJ Li, ML Zheng, S Xu, DX Tang, YF Han

Abstract

Wilms' tumour is the most frequent malignant neoplasm of the kidney in children. Multimodal treatment was used in treating this tumour, and it has achieved the best results for any tumour group. We studied all the patients who underwent surgery for unilateral Wilms' tumour at Children's Hospital, Zhejiang University School of Medicine during the 15-year period from January 1992 through December 2006. A total of 92 patients were treated for the unilateral Wilms' tumour during the study period, among whom 11 patients were excluded out of this analysis due to the loss of first follow-up after discharge from the hospital. The overall survival of the 81 patients was 76.6%. Cox analysis revealed that anaplastic histology, stage III and without preoperative treatment are risk factors for Wilms' tumour. Pre-operative treatment plays an important role in the treatment of Wilms' tumour and it will lead to better outcome for the patients. Treatment for Wilms' tumour with anaplastic histology and tumour recurrence remains a big challenge in China. The overall survival is still lower than that in developed countries and multi-modality treatment should be optimised for Wilms' tumour patients in China.

Wilms'瘤（腎母細胞瘤）是兒童時期最為常見的惡性腫瘤。有多種治療方法可應用於Wilms'瘤的治療，並且對於不同組別的腫瘤病人均已獲得較好的治療療效。我們對浙江大學醫學院附屬兒童自1992年1月至2006年12月十五年內所有進行單側Wilms'瘤進行了手術治療的病人進行了回顧分析。共有92例單側Wilms'瘤病人接受了治療，其中11名病人由於出院後未覆診而被從本次回顧性研究分析中除外。81例病人總體存活率為76.6%。Cox 分析之後提示：間變性病理類型，分期III期以及外科手術前未經治療是影響Wilms'瘤預後的危險因素。術前治療在Wilms'瘤的治療中起著重要的作用，它可以改善病人的預後。在中國，對於退行性變的Wilms'瘤以及復發的腫瘤的治療仍然是難題。其總體的存活率仍然低於發達國家，應進一步優化綜合治療方法來治療Wilms'瘤。