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• General Information About Wilms Tumor and Other Childhood Kidney Tumors
• Stages of Wilms Tumor and Other Childhood Kidney Tumors
• Recurrent Wilms Tumor and Other Childhood Kidney Tumors
• Treatment Option Overview
• Treatment Options for Wilms Tumor and Other Childhood Kidney Tumors
• To Learn More About Wilms Tumor and Other Childhood Kidney Tumors

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Treatment Options for Wilms Tumor and Other Childhood Kidney Tumors

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Stage I Wilms Tumor

Treatment of stage I Wilms tumor with favorable histology may include the following:

• Nephrectomy with lymph node removal followed by combination chemotherapy.
• A clinical trial of nephrectomy with lymph node removal, followed by watchful waiting or new combinations of chemotherapy.

Treatment of stage I anaplastic Wilms tumor may include the following:

• Nephrectomy with lymph node removal followed by combination chemotherapy and radiation therapy to the flank (either side of the body between the ribs and hipbone) of the body.
• A clinical trial of nephrectomy with lymph node removal, followed by new combinations of chemotherapy with radiation therapy.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage I Wilms tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Stage II Wilms Tumor

Treatment of stage II Wilms tumor with favorable histology may include the following:

• Nephrectomy with removal of lymph nodes, followed by combination chemotherapy.
• A clinical trial of nephrectomy with removal of lymph nodes, followed by new combinations of chemotherapy.

Treatment of stage II anaplastic Wilms tumor may include the following:

• Nephrectomy with removal of lymph nodes, followed by radiation therapy to the abdomen and combination chemotherapy.
• A clinical trial of nephrectomy with removal of lymph nodes, followed by new combinations of chemotherapy with radiation therapy.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage II Wilms tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Stage III Wilms Tumor

Treatment of stage III Wilms tumor with favorable histology may include the following:

• Nephrectomy with removal of lymph nodes, followed by radiation therapy to the abdomen and combination chemotherapy.
• A clinical trial of nephrectomy with removal of lymph nodes, followed by radiation therapy to the abdomen and new combinations of chemotherapy.

Treatment of stage III anaplastic Wilms tumor may include the following:

• Nephrectomy with removal of lymph nodes, followed by radiation therapy to the abdomen and combination chemotherapy.
• Combination chemotherapy given before nephrectomy with removal of lymph nodes, followed by radiation therapy to the abdomen.
• Nephrectomy with removal of lymph nodes, followed by radiation therapy to the abdomen and combination chemotherapy.
• A clinical trial of nephrectomy with removal of lymph nodes, followed by new combinations of chemotherapy with radiation therapy.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage III Wilms tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Stage IV Wilms Tumor

Treatment of stage IV Wilms tumor with favorable histology may include the following:

• Nephrectomy with removal of lymph nodes, followed by radiation therapy to the abdomen and combination chemotherapy. If cancer has spread to the lungs, patients will also receive radiation therapy to the lungs.
• A clinical trial of nephrectomy with removal of lymph nodes, followed by chemotherapy for cancer that has spread only to the lungs, and by radiation therapy to the abdomen. If cancer in the lungs remains after chemotherapy, radiation therapy may be given.
• A clinical trial of nephrectomy with removal of lymph nodes, followed by chemotherapy, and radiation therapy to all places where cancer has spread.

Treatment of stage IV anaplastic Wilms tumor may include the following:

• Combination chemotherapy given before nephrectomy with removal of lymph nodes, followed by radiation therapy to the abdomen. If cancer has spread to the lungs, patients will also receive radiation therapy to the lungs.
• Nephrectomy with removal of lymph nodes, followed by radiation therapy to the abdomen and combination chemotherapy. If cancer has spread to the lungs, patients will also receive radiation therapy to the lungs.
• A clinical trial of nephrectomy with removal of lymph nodes, followed by new combinations of chemotherapy with radiation therapy.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage IV Wilms tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Stage V Wilms Tumor and those at high risk of developing Wilms tumor

Treatment of stage V Wilms tumor may be different for each patient and may include:

• Combination chemotherapy to shrink the tumor, followed by repeat imaging at 4 to 8 weeks to guide the choice of further therapy (partial nephrectomy, biopsy, continued chemotherapy, and/or radiation therapy).
• A biopsy of the kidneys is followed by chemotherapy to shrink the tumor. Second-look surgery is done to remove as much of the cancer as possible. This may be followed by more chemotherapy and/or radiation therapy if cancer remains after surgery.
• A clinical trial of chemotherapy to shrink the tumor, followed by repeat imaging at 6 and 12 weeks to guide the choice of further therapy (surgery, biopsy, continued chemotherapy and/or radiation therapy).

If a kidney transplant is needed because of kidney problems, it is delayed until 1 to 2 years after treatment is completed and there are no signs of cancer.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage V Wilms tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Inoperable Tumors

Sometimes the tumor is inoperable (cannot be removed by surgery) because it is too close to important organs or blood vessels, too large to remove, or there is cancer in both kidneys. In this case, chemotherapy may be given to reduce the size of the tumor so as much tumor as possible can be removed in surgery. Radiation therapy is given after surgery.

Clear Cell Sarcoma of the Kidney

Treatment of clear cell sarcoma of the kidney may include the following:

• Nephrectomy with removal of lymph nodes followed by combination chemotherapy and radiation therapy to the abdomen.
• A clinical trial of nephrectomy with lymph node removal, with or without radiation therapy to the abdomen, and new combinations of chemotherapy.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with clear cell sarcoma of the kidney. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Rhabdoid Tumor of the Kidney

There is no standard treatment for rhabdoid tumor of the kidney. Treatment is usually within a clinical trial and may include new combinations of chemotherapy and radiation therapy.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with rhabdoid tumor of the kidney. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Neuroepithelial Tumor of the Kidney

There is no standard treatment for neuroepithelial tumor of the kidney. Treatment is usually within a clinical trial. It may be treated in the same way that Ewing family of tumors or primitive neuroectodermal tumors are treated. See the PDQ summary on Ewing Sarcoma Family of Tumors Treatment for more information.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with peripheral primitive neuroectodermal tumor of the kidney. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Congenital Mesoblastic Nephroma

Treatment for congenital mesoblastic nephroma is usually surgery with or without chemotherapy.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with congenital mesoblastic nephroma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Renal Cell Cancer

Treatment of renal cell cancer is usually nephrectomy with removal of lymph nodes. In some cases, treatment may be a partial nephrectomy with removal of lymph nodes. If cancer has spread, treatment may include biologic therapy. See the PDQ summary on Renal Cell Cancer Treatment for more information.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood renal cell carcinoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Nephroblastomatosis

Treatment of nephroblastomatosis may include the following:

• Combination chemotherapy.
• Partial nephrectomy may be done to keep as much kidney function as possible.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with diffuse hyperplastic perilobar nephroblastomatosis. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Recurrent Wilms Tumor and Other Childhood Kidney Tumors

Treatment of recurrent Wilms tumor may include the following:

• Combination chemotherapy, surgery, and radiation therapy, with or without stem cell transplant, using the child's own blood stem cells.
• A clinical trial of targeted therapy.

Treatment of recurrent clear cell sarcoma of the kidney may include chemotherapy. Treatment of clear cell sarcoma of the kidney that has recurred in the brain may include chemotherapy, surgery, and radiation therapy.

Treatment of recurrent rhabdoid tumor of the kidney, neuroepithelial tumor of the kidney, and renal cell cancer is usually within a clinical trial.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent Wilms tumor and other childhood kidney tumors. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.