Despite an impressive increase in survival rate over the past decades, there is still a need to improve the survival of specific subgroups of Wilms tumor (anaplastic, metastatic, and bilateral) and to decrease the late effects of treatment in terms of renal function and heart toxicity. We aim to explore new areas of improvement, from diagnosis to treatment: in the field of radiology the increased use of MRI and exploration of its diffusion-weighted imaging capabilities to predict WT histology at diagnosis and for preoperative assessment; in biology the emergence of new biomarkers that could be integrated into the decision-making process; and surgical techniques with more accurate indication of nephron-sparing surgery that is no longer reserved for bilateral WT and the minimally invasive approach. The long-term outcome of patients with WT should thus be a strong indicator of the improvement in adapting and personalizing the treatment to each individual.
Seminars in pediatric surgery. 2016 Sep 04 [Epub]
Sabine Irtan, Peter F Ehrlich, Kathy Pritchard-Jones
Department of Pediatric Surgery, APHP Hôpital Armand Trousseau, Research Unit St Antoine Inserm UMRS.938, Sorbonne Universités, UPMC Univ Paris 06, Paris, France., Pediatric Surgery Department, C.S. Mott Children׳s Hospital, University of Michigan, Ann Arbor, Michigan., Cancer Section, Developmental Biology & Cancer Programme, Institute of Child Health, University College London, 30 Guilford St, London WC1N 1EH, UK. Electronic address: .