Tumor de Wilms' na criança: revisão de 38 casos.

Abstract

Analysis of the incidence of the Nephroblastoma and of its clinic, echographic and radiologic aspects. Review of 38 cases handled in the Pediatric Surgery Service of Santa Maria Hospital between January 1960 and January 1987. In addition to the distribution by age and stadiation, the results were studied in 3 groupings corresponding to successive therapeutic phases along this period. The survival is more favourable in the etary group under 3 years old and does not differ substantially in stages I and II. In the analysis of the prognostic to the therapeutic sequences, there was an evident improvement of survival from 0% before 1966 (Surgery and Radiotherapy) to 46.15% in the second phase, 1966-76, with the introduction of Chemotherapy (Actinomycina D). In the last phase after 1977, using the therapeutic scheme of National Wilms Tumour Study (NWTS) survival reached 80.95%. Trying to correlate the prognostic with the histologic type, it turns out to be difficult to make a criterious characterization in the cases submitted to pre-operative Radio and/or Chemotherapy. The advantage of this therapeutic attitude in parallel with the faulaification of the histologic type and the Tumour stadiation is hereby discussed.