Thanks to great strides that have been made in Wilms’ tumor treatment, today nearly nine out of ten children with Wilms’ tumor can be cured. MSK Kids most often treats Wilms’ tumor first with surgery to remove the affected kidney, then with chemotherapy and often radiation.

The best treatment for your child depends on a few factors:

• the stage of the tumor at diagnosis
• whether it is a favorable or unfavorable tumor
• chromosome changes that may be present

Surgery for Wilms’ Tumor

Your child may have one of these procedures based on the tumor’s stage:

• Radical nephrectomy: This removes the entire kidney and the tissue around it, including the ureter (the tube that carries urine from the kidney to the bladder). The surgeons also take out the adrenal gland, surrounding fatty tissues, and nearby lymph nodes. The other kidney is left alone.
• Partial nephrectomy: This removes the tumor and part of the kidney. Children who have tumors in both kidneys may be good candidates for this surgery. It’s also a good option for children with a tumor in one kidney who are predisposed to developing one in the other kidney. 
• Simple nephrectomy: This removes just the kidney without any nearby tissue.

If the tumor is very large, we may give chemotherapy to shrink it before surgery. This makes it easier to remove.

Chemotherapy for Wilms’ Tumor

For stage I and stage II tumors with normal-looking cells, surgery and chemotherapy are often enough to cure Wilms’ tumor. If your child’s tumor comes back after treatment, we recommend either stronger chemotherapy, newer treatments that target specific genetic mutations in the tumor, or a clinical trial.

Radiation Therapy for Wilms’ Tumor

For children with advanced Wilms’ tumors —stage II tumors with abnormal-looking cells, stage III tumors, stage IV tumors, and tumors that come back after treatment — we often combine chemotherapy and surgery with radiation.