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Treatment of stage III Wilms tumor
Source: Wilms Tumor and Other Childhood Kidney Tumors Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: April 15, 2025 · Captured 2026-09-09.
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Context: Wilms Tumor / Treatment of Wilms Tumor
Table 6 provides an overview of the standard treatment options and survival data for patients with stage III Wilms tumor, based on published results.
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For information about patients classified as stage III purely based on local spill, see the Treatment of stage II Wilms tumor section.
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| Histology | 4-Year RFS or EFS | 4-Year OS | Treatmentb |
|---|---|---|---|
| DA = diffuse anaplastic; EFS = event-free survival; FA = focal anaplastic; FH = favorable histology; LOH = loss of heterozygosity; OS = overall survival; RFS = relapse-free survival; XRT = radiation therapy. | |||
| aSource: Grundy et al.,[110] Dome et al.,[183] Fernandez et al.,[242] Dix et al.,[264] Daw et al.,[267] and Armstrong et al.[276] | |||
| bFor chemotherapy regimen descriptions, see Table 2. | |||
| FH (all patients) | 88% EFS | 97% | Nephrectomy + lymph node sampling followed by abdominal XRT and regimen DD-4A |
| FH (without LOH of 1p and/or 16q) and positive lymph nodes (n = 109) | 82% EFS | 97% | Nephrectomy + lymph node sampling followed by abdominal XRT and regimen DD-4A |
| FH (without LOH of 1p and/or 16q) and negative lymph nodes (n = 169) | 97% EFS | 99% | Nephrectomy + lymph node sampling followed by abdominal XRT and regimen DD-4A |
| FH (with LOH of 1p and 16q) (n = 31) | 87% EFS | 94% | Nephrectomy + lymph node sampling followed by abdominal XRT and regimen M |
| FH (with LOH of 1p and 16q) and negative lymph nodes (n = 12) | 92% | 92% | Nephrectomy + lymph node sampling followed by abdominal XRT and regimen M |
| FH (with LOH of 1p or 16q) and negative lymph nodes (n = 13) | 85% | 92% | Nephrectomy + lymph node sampling followed by abdominal XRT and regimen M |
| FH (with LOH of 1p or 16q) and negative lymph nodes (n = 68) | 87% | 97% | Nephrectomy + lymph node sampling followed by abdominal XRT and regimen DD-4A |
| FH (with LOH of 1p or 16q) and positive lymph nodes (n = 48) | 74% | 92% | Nephrectomy + lymph node sampling followed by abdominal XRT and regimen DD-4A |
| FA | 70% RFS | 79% (n = 10) | Nephrectomy + lymph node sampling followed by abdominal XRT and regimen DD-4A |
| FA (preoperative treatment) | 71% RFS | 71% (n = 7) | Preoperative treatment with regimen DD-4A followed by nephrectomy + lymph node sampling and abdominal XRT |
| DA | 46% EFS | 53% (n = 16) | Preoperative treatment with regimen I followed by nephrectomy + lymph node sampling and abdominal XRT |
| DA | 82% EFS | 91% (n = 23) | Immediate nephrectomy + lymph node sampling followed by abdominal XRT and regimen UH1 |
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