Update Course Rewind: Updates in Wilms Management 2024

European colleagues following SIOP guidelines would offer chemotherapy without biopsy for Wilms tumor.

At COG (Children's Oncology Group) sites in North America, the approach would be resection and diagnosis.

Doxorubicin would be added to chemotherapy even for a low stage tumor under certain conditions.

Doxorubicin is added when there is loss of heterozygosity at 1P and 16Q.

Loss of heterozygosity at 1P and 16Q shows higher recurrence in Wilms tumor.

For surgeons, there will be more waiting for the biology results before determining if chemotherapy is needed, affecting decisions about port placement.

It is not accurate to tell patients that if they are less than 2 years of age and the tumor is less than 550g, they will not need chemotherapy, because biology studies may require adding chemotherapy.

Chemotherapy must be added if there is loss of heterozygosity at 1P and 16Q.

Even in stage 1 favorable histology, chemotherapy is still added if there is loss of heterozygosity at 1P and 16Q.