Current treatment for Wilms tumor: COG and SIOP standards

Abstract

Background: Wilms tumor (WT) is the most common renal malignant tumor in children. It occurs primarily at preschool age. The purpose of this review is to present current standards of diagnosis and treatment of WT around the world. Data sources: All the recent literature on diagnosis and treatment of WT were searched and reviewed. Results: Most cases with WT are sporadic. The current survival in patients with WT is high (90%). Involvement of mutidisciplinary collaborative groups in the diagnosis and treatment of WT. National Wilms Tumor Study Group (NWTSG)/Children's Oncology Group (COG) and The International Society of Paediatric Oncology (SIOP) are two major guidelines used for the current management of WT worldwide. The major difference exists in the two guidelines is the timing of surgery: SIOP recommends using preoperative chemotherapy, and NWTSG/COG prefers using primary surgery before any adjuvant treatments. Conclusions: Most patients with WT have good overall survival outcomes. Further studies should be highlighted on how to use chemotherapy and radiotherapy under more accurate risk-stratified strategies. Surgeons must be more focusing on how to maximize preoperative and postoperative treatment possibilities for achieving optimal results of patients with WT.