Renal cell carcinoma in children under 14 years old: long-term survival

Objectives To assess the treatment and long-term survival of children under 14 years old operated upon for renal cell carcinoma (RCC). Patients and methods The records of five patients (aged 2, 4, 6, 9 and 13 y ears) who had been treated for RCC between 1982 and 1993 were reviewed. All had undergone nephrectomy with (two) or without (three) regional lymphaden ectomy. After surgery four patients received chemotherapy (vincristine with actinomycin-D, three, vinblastine, one), and two with advanced-stage disea se received other agents (interferon alpha, interleukin-2). They were follo wed for 5 to 15 years. Results Three patients with stage I-II RCC were well. at 13, 15 and 15 year s after treatment. Of the two patients with regional lymph node involvement (stage III) one was well 5 years after surgery while the ether developed h epatic, lung and bone metastases, and died 2 years after presentation, Conclusion The prognosis and long-term survival of children under 14 years old with RCC is very good for those with low-stage tumours, Nephrectomy wit h complete tumour extirpation is the main mode of treatment. For advanced-s tage tumours, the role of adjuvant chemotherapy and/or biological agents mu st be defined more clearly.