Title: Histopathology and prognosis of Wilms tumorResults from the first national wilms' tumor study
Abstract: CancerVolume 41, Issue 5 p. 1937-1948 ArticleFree Access Histopathology and prognosis of Wilms tumor Results from the first national wilms' tumor study J. B. Beckwith MD, Corresponding Author J. B. Beckwith MD Departments of Pathology and Pediatrics, University of Washington, School of Medicine and the Department of Laboratories, Children's Orthopedic Hospital and Medical center, Seattle, WashingtonChildren's Orthopedic Hospital and Medical Center, P.O. Box 5371, Seattle, Washington 98105===Search for more papers by this authorN. F. Palmer MB, BS, N. F. Palmer MB, BS Departments of Pathology and Pediatrics, University of Washington, School of Medicine and the Department of Laboratories, Children's Orthopedic Hospital and Medical center, Seattle, WashingtonSearch for more papers by this author J. B. Beckwith MD, Corresponding Author J. B. Beckwith MD Departments of Pathology and Pediatrics, University of Washington, School of Medicine and the Department of Laboratories, Children's Orthopedic Hospital and Medical center, Seattle, WashingtonChildren's Orthopedic Hospital and Medical Center, P.O. Box 5371, Seattle, Washington 98105===Search for more papers by this authorN. F. Palmer MB, BS, N. F. Palmer MB, BS Departments of Pathology and Pediatrics, University of Washington, School of Medicine and the Department of Laboratories, Children's Orthopedic Hospital and Medical center, Seattle, WashingtonSearch for more papers by this author First published: May 1978 https://doi.org/10.1002/1097-0142(197805)41:5<1937::AID-CNCR2820410538>3.0.CO;2-UCitations: 970AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract Detailed histological analysis of 427 cases entered on the first national Wilms' tumor study revealed that lesions with foci of marked cytological atypism (anaplasia), and those composed predominantly of sarcomatous stroma, were associated with unfavorable outcome. Twenty-five patients had anaplasia, and 24 had sarcomatous lesions of which a total of 28 (57.1%) died of tumor. Three hundred and seventy-eight patients had tumors which showed neither of these features, and only 26 (6.9%) died of tumor. Seven of ten deaths due to tumor in patients diagnosed before two years of age were associated with sarcomatous lesions. three sarcomatous patterns were recognized, of which one, designated “clear cell” sarcoma, had a predilection for bony metastases. Using criteria defined and illustrated in this paper it is possible to identify in advance those patients likely to do poorly using current therapeutic approaches. Reference 1 Beckwith, J. B.: Mesenchymal renal neoplasms revisited. J. Pediat. Surg. 9: 803– 805, 1974. 2 Bennington, J. L., and Beckwith, J. B.: Tumors of the kidney, renal pelvis, and ureter, Second Series, Fascicle 12, Atlas of Tumor Pathology. Washington D.C. Armed Forces Institute of Pathology, 1975, p. 31. 3 Bodian, M., and Rigby, C. C.: The pathology of nephroblastoma, In Tumors of the Kidney and Ureter. Vol 5 of Neoplastic Disease at Various Sites. E. Riches (Ed.), Baltimore, Williams and Wilkins, 1964, pp. 219– 234. 4 Bolande, R. P.: Congenital mesoblastic nephroma of infancy. Perspect. Pediatric Pathol. 1: 227– 250, 1973. 5 Breslow, N. E., Palmer, N. F., Hill, L. R., Buring, J., and D'Angio, G. J.: Wilms' Tumor: Prognostic factors for patients without metastases at diagnosis. Results of the National Wilms' Tumor Study. Cancer 41: 326– 332, 1978. 6 Chatten, J.: Epithelial differentiation in Wilms' tumor: A clinico-pathological appraisal. Perspect. Pediatric Pathol. 3: 225– 254, 1976. 7 Currie, D. P., Daly, J. T., Grimes, J. H., and Anderson, E. E.: Wilms' tumor: A clinical pathological correlation. J. Urol. 109: 495– 550, 1973. 8 D'Angio, G. J., Evans, A. E., Breslow, N. E., Beckwith, B., Bishop, H., Feigl, P., Goodwin, W., Leape, L. L., Sinks, L. F., Sutow, W., Tefft, M., and Wolff, J.: The treatment of Wilms' tumor. Cancer 38: 633– 646, 1976. 9 D'Angio, G. J., Beckwith, J. B., Bishop, H. C., Breslow, N., Evans, A. E., Goodwin, W. E., King, L. R., Pickett, L. K., Sinks, L. F., Sutow, W. W., and Wolff, J. A.: The National Wilms' Tumor Study: A progress report. Proceedings of the Seventh National Cancer Conference American Cancer Society, 1973. p 627– 636. 10 Hansemann, D.: Ueber die Anaplasie der Geschwülstzellen und die asymmetrische Mitose, Virchows Arch. F. Pathol. Anat. 129: 436– 447, 1992. 11 Hardwick, D. F., and Stowens, D.: Wilms' tumors, J. Urol. 85: 903– 910, 1961. 12 Jereb, B., and Sandstedt, B.: Structure and size versus prognosis in nephroblastoma. Cancer 31: 1473– 1481, 1973. 13 Kempson, R. L.: Mitosis counting-II. Human Pathol.: Cancer 7, 482– 483, 1976. 14 Kidd, J. K.: Exclusion of certain renal neoplasms from the category of Wilms' tumor. Am. J. Pathol. 59: 16A, 1970. 15 Lawler, W., Marsden, H. B., and Palmer, M. K.: Wilms' tumor: Histologic variation and prognosis. Cancer 36: 1122– 1126, 1975. 16 Lemerle, J., Tournade, M., and Gerard-Marchant, R.: Wilms' tumor: Natural history and prognostic factors. Cancer 37: 2557– 2566, 1976. 17 Perez, C. A., Kaiman, H. A., Keith, J., Mill, W. B., Vietti, T. J., and Powers, W. E.: Treatment of Wilms' tumor and factors affecting prognosis. Cancer 32: 609– 617, 1973. 18 Wigger, H. J.: Fetal mesenchymal hamartoma of kidney. A tumor of secondary mesenchyma. Cancer 36: 1002– 1008, 1975. Citing Literature Volume41, Issue5May 1978Pages 1937-1948 ReferencesRelatedInformation