PMID- 1849987
OWN - NLM
STAT- MEDLINE
DCOM- 19910521
LR  - 20170210
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 9
IP  - 5
DP  - 1991 May
TI  - Wilms' tumor: status report, 1990. By the National Wilms' Tumor Study Committee.
PG  - 877-87
AB  - Rapid advances in the understanding of Wilms' tumor (WT) and its management are 
      being made both in the laboratory and the clinic. Molecular genetic research has 
      implicated loss of a tumor suppressor gene on the short arm of chromosome 11 as 
      one of the pathways responsible for the development of the neoplasm. 
      Preconception maternal (hair dyes) and paternal (occupation) exposures to 
      environmental agents have been the subject of epidemiologic studies of possible 
      risk factors. Histopathologic analyses have identified several different and less 
      common tumor types among those previously aggregated under the WT rubric. WT 
      itself has been subdivided into the so-called favorable histology (FH) and 
      anaplastic forms, the prognosis being worse for the latter. Clinical research has 
      standardized management by surgery, chemotherapy, and radiation therapy (RT) and 
      furthered the identification of risk factors. Patients can now be stratified 
      according to tumor type and stage, and the intensity of treatment modulated 
      accordingly; eg, RT at low doses is used in only 25% of National Wilms' Tumor 
      Study (NWTS) patients without distant metastases. Before the NWTS, it had been 
      given to almost all and at higher doses. Chemotherapy, whether given pre- or 
      postoperatively, is based on dactinomycin and vincristine with Adriamycin [( ADR] 
      doxorubicin; Adria Laboratories, Columbus, OH) added for high-risk patients. The 
      currently used NWTS combined modality therapy for WT patients has dramatically 
      improved survival rates; 95% now are alive 2 years after treatment. Remaining 
      questions are the identification of the late effects of the treatments used and 
      the further refinement of therapy to reduce iatrogenic complications to a 
      minimum.
LA  - eng
GR  - CA-42326/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PT  - Review
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
SB  - IM
MH  - Child
MH  - Humans
MH  - Kidney Neoplasms/genetics/*therapy
MH  - Wilms Tumor/genetics/*therapy
RF  - 66
EDAT- 1991/05/01 00:00
MHDA- 1991/05/01 00:01
CRDT- 1991/05/01 00:00
PHST- 1991/05/01 00:00 [pubmed]
PHST- 1991/05/01 00:01 [medline]
PHST- 1991/05/01 00:00 [entrez]
AID - 10.1200/JCO.1991.9.5.877 [doi]
PST - ppublish
SO  - J Clin Oncol. 1991 May;9(5):877-87. doi: 10.1200/JCO.1991.9.5.877.