An update on the management of Wilmsʹ tumour

Aims To review the management of Wilmsʹ tumour. Methods A search of the literature was performed using the PubMed database (1966 to May 2006) with the search terms ‘Wilms’ and either ‘tumour/tumor’ or ‘cancer’ or ‘carcinoma’. This was augmented by manual searches of publications. Findings The success of clinical trials in Wilmsʹ tumour patients over the past 30 years has led to an overall survival of 85% and the introduction of less aggressive chemotherapeutic regimes for patients. Large randomised controlled trials have been published on the management of Wilmsʹ tumour by various collaborative groups, including the National Wilmsʹ Tumour Study Group (NWTSG) in North America and the Société Internationale dʹOncologie Pédiatrique (SIOP) plus the United Kingdom Childrenʹs Cancer Study Group (UKCCSG) in Europe. Conclusions Controversy exists as to the best approach to the management of these children with regard to neoadjuvant chemotherapy. Challenges remain in the identification of histological and molecular risk factors for the stratification of treatment intensity.