Wilms' tumor staging: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Wilms' tumor}} | {{Wilms' tumor}} | ||
{{CMG}}; {{AE}} {{ | {{CMG}}; {{AE}} {{SSW}} | ||
==Overview== | ==Overview== | ||
Staging of wilms tumor is done based upon the extent of tumor [[Anatomy|anatomically]] and not done on the basis of its [[genetics]], [[histology]] or [[molecular marker]]<nowiki/>s. Extensive disease and worse [[prognosis]] is denoted by a higher stage. The staging systems that are currently used are National Wilms Tumor Study (NWTS) system and International Society of Pediatric Oncology (SIOP) system. Both these systems divide wilms tumor into 5 stages. | |||
==Staging== | ==Staging== | ||
* Staging of wilms tumor is done based upon: | * Staging of wilms tumor is done based upon: | ||
** Extent of tumor anatomically. | ** Extent of [[Tumor cell|tumor]] anatomically. | ||
** It is not done on the basis of its genetics, histology or molecular markers. | ** It is not done on the basis of its [[genetics]], histology or molecular markers. | ||
* Extensive disease and worse prognosis is denoted by a higher stage. | * Extensive disease and worse prognosis is denoted by a higher stage. | ||
* Patients suffering from a higher stage tumor get more aggressive treatment modalities. | * Patients suffering from a higher stage tumor get more aggressive treatment modalities. | ||
Line 19: | Line 19: | ||
* This system is used throughout United States and Canada. | * This system is used throughout United States and Canada. | ||
* It is based on the evaluations done during surgery before the administration of surgery. | * It is based on the evaluations done during surgery before the administration of surgery. | ||
* According to this system wilms tumor is divided into following stages.<ref name="pmid16314292">{{cite journal |vauthors=Metzger ML, Dome JS |title=Current therapy for Wilms' tumor |journal=Oncologist |volume=10 |issue=10 |pages=815–26 |date=2005 |pmid=16314292 |doi=10.1634/theoncologist.10-10-815 |url=}}</ref> | |||
** '''Stage 1''' | |||
*** Tumor is limited only to the [[kidney]]. | |||
*** When the tumor is resected the [[capsule]] is intact. | |||
*** Resected tumor shows no evidence of involvement of renal sinus vessel. | |||
** '''Stage 2''' | |||
*** Tumor is extended beyond the [[kidney]], but can be resected completely. | |||
*** Tumor margins go beyond the renal capsule. | |||
*** It extends into the renal capsule, soft tissues and blood vessels beyond the renal [[Parenchymal|parenchyma]]. | |||
*** But all this is within the margins of the resected tumor. | |||
** '''Stage 3''' | |||
*** Complete tumor cannot be resected. | |||
*** The remaining tumor is confined within the [[abdomen]]. | |||
*** Residual tumor remaining within abdomen includes : | |||
**** Regional [[lymph nodes]] | |||
**** [[Peritoneal]] surface | |||
**** Incomplete resection of tumor | |||
**** Tumor spillage | |||
** '''Stage 4''' | |||
*** In stage 4 either [[Metastasis|hematogenous metastasis]] are present or [[lymph nodes]] are affected beyond the abdominopelvic region. | |||
*** [[Metastasis|Hematogenous metastasis]] include sites like: | |||
**** [[Lung]] | |||
**** [[Liver]] | |||
**** [[Bone]] | |||
**** [[Brain]] | |||
** '''Stage 5''' | |||
*** When Wilms tumor is diagnosed, bilateral renal involvement is seen. | |||
*** Each kidney has to be staged separately. | |||
=== SIOP staging === | |||
* This system is followed in Europe. | |||
* This system is based on the surgical evaluation done after the size of the tumor is reduced after [[chemotherapy]]. | |||
* According to this system wilms tumor is divided into following stages. | * According to this system wilms tumor is divided into following stages. | ||
** Stage 1 | ** '''Stage 1''' | ||
*** | *** Tumor is limited only to the kidney. | ||
* | *** If the tumor extends beyond the kidney, a fibrous pseudocapsule surrounds it. | ||
*** Tumor can be found in the pelvic system but should not involve ureter walls. | |||
** '''Stage 2''' | |||
*** Tumor is extended beyond the kidney, but can be resected completely. | |||
*** After resection there is no evidence beyond the resection margins. | |||
** '''Stage 3''' | |||
*** After tumor is resected surgically, some residual [[tumor]] still remains. | |||
*** This remainder tumor is confined to the [[abdomen]]. | |||
*** No hematogenous metastasis is present. | |||
** '''Stage 4''' | |||
*** Hematogenous spread os positive. | |||
*** This spread is to: | |||
**** [[Lungs]] | |||
**** [[Liver]] | |||
**** [[Bone]] | |||
**** [[Brain]] | |||
*** Lymph nodes can be involved beyond the abdominopelvic region. | |||
** '''Stage 5''' | |||
*** Both kidneys are involved at the time of the diagnosis. | |||
==References== | ==References== |
Latest revision as of 05:27, 10 July 2018
Wilms' tumor Microchapters |
Diagnosis |
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Treatment |
Case Studies |
Wilms' tumor staging On the Web |
American Roentgen Ray Society Images of Wilms' tumor staging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sargun Singh Walia M.B.B.S.[2]
Overview
Staging of wilms tumor is done based upon the extent of tumor anatomically and not done on the basis of its genetics, histology or molecular markers. Extensive disease and worse prognosis is denoted by a higher stage. The staging systems that are currently used are National Wilms Tumor Study (NWTS) system and International Society of Pediatric Oncology (SIOP) system. Both these systems divide wilms tumor into 5 stages.
Staging
- Staging of wilms tumor is done based upon:
- Extensive disease and worse prognosis is denoted by a higher stage.
- Patients suffering from a higher stage tumor get more aggressive treatment modalities.
- The staging systems that are currently used are:[1]
- National Wilms Tumor Study (NWTS) system.
- International Society of Pediatric Oncology (SIOP) system.
NWTS system
- This system is used throughout United States and Canada.
- It is based on the evaluations done during surgery before the administration of surgery.
- According to this system wilms tumor is divided into following stages.[2]
- Stage 1
- Stage 2
- Tumor is extended beyond the kidney, but can be resected completely.
- Tumor margins go beyond the renal capsule.
- It extends into the renal capsule, soft tissues and blood vessels beyond the renal parenchyma.
- But all this is within the margins of the resected tumor.
- Stage 3
- Complete tumor cannot be resected.
- The remaining tumor is confined within the abdomen.
- Residual tumor remaining within abdomen includes :
- Regional lymph nodes
- Peritoneal surface
- Incomplete resection of tumor
- Tumor spillage
- Stage 4
- In stage 4 either hematogenous metastasis are present or lymph nodes are affected beyond the abdominopelvic region.
- Hematogenous metastasis include sites like:
- Stage 5
- When Wilms tumor is diagnosed, bilateral renal involvement is seen.
- Each kidney has to be staged separately.
SIOP staging
- This system is followed in Europe.
- This system is based on the surgical evaluation done after the size of the tumor is reduced after chemotherapy.
- According to this system wilms tumor is divided into following stages.
- Stage 1
- Tumor is limited only to the kidney.
- If the tumor extends beyond the kidney, a fibrous pseudocapsule surrounds it.
- Tumor can be found in the pelvic system but should not involve ureter walls.
- Stage 2
- Tumor is extended beyond the kidney, but can be resected completely.
- After resection there is no evidence beyond the resection margins.
- Stage 3
- Stage 4
- Stage 5
- Both kidneys are involved at the time of the diagnosis.
- Stage 1