Wilms's tumour—an improved prognosis

An unselected series of 22 consecutive children with Wilms's tumour seen during the period 1967-71 is described. The management of the patients consisted of operation, radiotherapy, and chemotherapy in varying combinations. The following guide-lines for treatment are suggested: early operation by a transabdominal approach, abdominal irradiation for most patients, both immediate and maintenance chemotherapy, and aggressive treatment of metastatic disease should it occur. The 2-year disease-free survival figures for this series, in the order of 80%, equals the best previously reported and emphasizes the improved prognosis for children with this tumour.