Wilms' tumor staging: Difference between revisions
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* 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. | * 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 | ** '''Stage 1''' | ||
*** Tumor is limited only to the kidney. | *** Tumor is limited only to the kidney. | ||
*** When the tumor is resected the capsule is intact. | *** When the tumor is resected the capsule is intact. | ||
*** Resected tumor shows no evidence of involvement of renal sinus vessel. | *** Resected tumor shows no evidence of involvement of renal sinus vessel. | ||
** Stage 2 | ** '''Stage 2''' | ||
*** Tumor is extended beyond the kidney, but can be resected completely. | *** Tumor is extended beyond the kidney, but can be resected completely. | ||
*** Tumor margins go beyond the renal capsule. | *** Tumor margins go beyond the renal capsule. | ||
*** It extends into the renal capsule, soft tissues and blood vessels beyond the renal parenchyma. | *** 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. | *** But all this is within the margins of the resected tumor. | ||
** Stage 3 | ** '''Stage 3''' | ||
*** Complete tumor cannot be resected. | *** Complete tumor cannot be resected. | ||
*** The remaining tumor is confined within the abdomen. | *** The remaining tumor is confined within the abdomen. | ||
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**** Incomplete resection of tumor | **** Incomplete resection of tumor | ||
**** Tumor spillage | **** 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: | |||
**** Lung | |||
**** Liver | |||
**** Bone | |||
**** Brain | |||
** | ** '''Stage 5''' | ||
*** When wilms tumor is diagnosed, bilateral renal involvement is seen. | |||
*** Each kidney has to be staged separately. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} |
Revision as of 21:42, 3 June 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: Shanshan Cen, M.D. [2]
Overview
There are 5 stages of wilms' tumor based on both the results of the imaging studies and the surgical and pathologic findings at nephrectomy.
Staging
- Staging of wilms tumor is done based upon:
- Extent of tumor anatomically.
- 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.
- 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
- 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 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:
- Lung
- Liver
- Bone
- Brain
- Stage 5
- When wilms tumor is diagnosed, bilateral renal involvement is seen.
- Each kidney has to be staged separately.
- Stage 1