PROGRESS AND CONTROVERSIES IN MODERN TREATMENT OF WILMS-TUMORS

During the past 25 years the treatment of Wilms' tumors has been refin ed owing to a series of thoroughly performed clinical studies. The ove rall prognosis is currently 80% (long-term cures), but different thera peutic issues are still discussed controversially, especially the ques tion of preoperative treatment. A number of different drugs have prove d effective in the treatment of Wilms' tumors. It remains to be determ ined as to which drug combinations are the most effective for which hi stologic sub-type and which stage of disease. It seems that these ques tions can be answered only if further studies consequently implicate a nalyses of early and long-term toxicities. The same is true for analys es of peri- and postoperative complications. Radiotherapy plays a role in about 50% of cases. Special subtypes require modified strategies, and the optimal treatment for high-risk histologic types has not yet b een found.