Abstract

Twenty-nine Wilms' tumors of 144 resected renal neoplasms during the period 1968 ti 1982, are reviewed. Twenty-six cases are analyzed clinically and 25 cases are reexamined microscopically. Classification of the tumor and clinical staging are based on the National Wilms' Tumor Study. The clinical group Ⅰ, Ⅱ, Ⅲ were 13, 6, 7 cases, respectively. The epithelial predominent, mixed, blastemal predominent and stromal predominent types were 3, 8, 5 and 9 cases, respectively. Eleven cases showed diffuse anaplasia. Four of them were stromal, diffuse anaplasia and the types of malignancy were rhabdomyosarcoma(3 cases) and clear cell sarcoma(1 case). Gross findings of the tumors were greatly variable, however, those matched well to the microscopic findings. So classification based on gross as well as microscopic findings was thought to be superior to that based on simple collection of microscopic slides. Five cases showing no evidence of recurrence or metastasis during the period of follow-up more than one year and two cases with metastasis but survival over 2 years are classified into good prognostic group. Four of them were stromal, no anaplasia type and clinical group 1. Six cases showing widespread metastasis or rapid recurrence of tumor resulting in death or giving up the treatment were classified into poor prognostic group. Factors related to their poor prognosis were older age, high clinical stage and histologic features of anaplasia. All the cases with poor prognosis showed evidences of recurrence or metastasis within one year. The resected kidneys of the cases with good prognosis was heavier than those of the cases with poor prognosis. Six cases showed significant rhabdoid differentiation. Three cases were associated with renal dysplasia. Two cases were adult Wilms' tumor.