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Question 6#

The predicted 4-year survival rate of a child with a Wilms tumor that is confined to one kidney and is grossly excised is:

a. 24%
b. 38%
c. 68%
d. 97%

Correct Answer is D

Comment:

Following nephroureterectomy for Wilms tumor, the need for chemotherapy and/or radiation therapy is determined by the histology of the tumor and the clinical stage of the patient (Table below). Essentially, patients who have disease confined to one kidney that is completely excised surgically receive a short course of chemotherapy and can expect a 97% 4-year survival, with tumor relapse rare after that time. Patients with more advanced disease or with unfavorable histology receive more intensive chemotherapy and radiation. Even in stage IV, cure rates of 80% are achieved. The survival rates are worse in the small percentage of patients considered to have unfavorable histology.

Staging of Wilms tumor: