WILMS-TUMOR IN ADULTS

Wilms' tumor in adults is rare and preoperative diagnosis may be diffi cult. Tumor stage and histology are the main determinants of outcome. Adult patients usually present with more advanced disease and the prog nosis is poorer than for children. Data concerning therapy are conflic ting. A multimodal procedure regardless of the stage with radical neph rectomy, chemotherapy with actinomycin D, vincristine and adriamycin, and radiotherapy to the renal bed has often been recommended. However, encouraging treatment results could also be achieved by different and less aggressive treatments depending on tumor stage. Recurrencies are common in advanced disease and usually affect the lungs. Salvage chem otherapy (cisplatin/etoposide) and pulmonary radiation has been effect ive in some cases. Experimental approaches such as allogenic bone marr ow transplantation deserve further consideration.