Wilms’ Tumor

Abstract

The current results of the treatment of nephroblastoma are one of the success stories of paediatric oncology. One of the first recorded reports of a nephrectomy for a Wilms’ tumour was by Mr. Jessop at Leeds Infirmary, who in 1877 reported in the Lancet (Annotations 1877); Max Wilms wrote his monograph on the tumour in 1899. Review of the literature shows that surgery alone, which was the usual treatment in the first half of this century, achieved cure rates of approximately 20%. These results were improved by the addition of radiation therapy, the first recorded case treated being reported by Friedlander (1916). The apparatus used was a Coolidge tube and the patient concerned had a tumour so large that no surgeon was willing to undertake its removal. There was a good response to treatment though this was short lived. The combination of radiotherapy and surgery improved survival rates significantly and until the 1950s this treatment was standard in most centres. Properative irradiation was relatively common; there was usually good response with reduction in the size of the tumour and subsequent removal was facilitated. In the situation where primary removal was possible it was usually the treatment of choice and this allowed the surgeon and pathologist to assess the extent of the spread of the tumour.