Wilms' Tumor: Treatment

Until the 1960s, most children with Wilms' tumor died of the disease. Today, thanks to modern treatment advances, nine out of ten children with Wilms' tumor are cured.

The three main types of Wilms' tumor treatment are surgery, chemotherapy, and radiation therapy. Before selecting a course of treatment or combination of treatments, our doctors examine the tumor cells under a microscope and consider all test results to determine how widely the tumor has spread — a process called staging.

Surgery is typically the main treatment for Wilms' tumor. Our surgeons perform one of three different procedures, depending on your child's tumor and stage:

  • Radical nephrectomy - This involves removing the entire kidney and the tissues surrounding it, including the ureter that carries urine from the kidney to the bladder. Surgeons also remove the adrenal gland, surrounding fatty tissues, and oftentimes nearby lymph nodes. The remaining kidney is left to continue filtering blood.
  • Simple Nephrectomy - This involves removing only the affected kidney, preserving the surrounding tissues.
  • Partial nephrectomy - This rarely used procedure involves removing the tumor and a section of the kidney surrounding the tumor. Children who have tumors in both kidneys may undergo this surgery.

In addition, our doctors typically use chemotherapy after surgery. For stage I tumors and stage II tumors with normal-looking cells (known as favorable histology), surgery and chemotherapy are often enough to cure the disease.

Surgery is usually combined with chemotherapy and radiation therapy for treating more advanced stages of Wilms' tumor, such as stage II tumors with abnormal-looking tumor cells (unfavorable histology), stage III tumors, stage IV tumors, and tumors that have returned after initial treatment.

If your child's tumor is either too large or located too close to vital organs and blood vessels for surgery, our experts may use chemotherapy and/or radiation therapy to shrink the tumor to a size that is more safely removed by surgery.