The treatment of Wilms' tumor: results from Royal Children's Hospital, Melbourne, 1967-1977.

A retrospective review of the treatment of Wilms' tumor from 1967 to 1977 at the Royal Children's Hospital, Melbourne, was undertaken, allowing a minimum 2-yr followup. Fifty-four (77%) of the 70 patients in the study are alive, with 23/25 (92%) in Stage I, 12/16 (75%) in Stage II, 12/19 (63%) in Stage III, and 7/9 (78%) in Stage IV. Survival was significantly better in Stage I disease, and those patients less than 5-yr-old at presentation. Recurrence of disease was significantly lower after the introduction of multiple courses of chemotherapy in 1971. Sixteen deaths occurred during the period: three infants from drug toxicity, four patients with "unfavorable" sarcomatous histology, and four patients with recurrent local disease, where irradiation had been confined to the tumor bed after tumor spill with recurrence beyond the irradiated field.