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Urology in Childhood pp 296–308Cite as

Neoplastic Disease: The Kidney

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Part of the book series: Handbuch der Urologie / Encyclopedia of Urology ((1020,volume 15 / 1))

Abstract

Undoubtedly the most important advances of the past decade in the treatment of nephroblastoma have been the introduction of an effective form of chemotherapy and the trend towards concentrating affected children in a small number of centres able fully to study and treat this disease. There has been a definite fall in overall mortality as a result, but the process of concentration of cases and the devising of treatment trials have not been without their problems. With the increasing efficiency and enthusiasm involved in a more hopeful treatment, results improve, and this improvement may be wrongly attributed to the new drug in use. Once any improvement in such a dangerous malady has been reported it then seems unethical to refuse a similar treatment in subsequent cases: therapy thus becomes more aggressive and more prolonged. This may well bring a bonus in the shape of a cure for some children with disseminated growth but is not without its dangers, as shown by the disastrous results of cytotoxic drugs used in neonates. It therefore becomes increasingly important to distinguish the highly malignant growths with poor prognosis from the simpler forms responding to simple surgery, thus reversing the previous trend of including under the term nephroblastoma (a mixed tumour) all growths arising in the kidney in children. The neonatal forms and the multilocular cysts, for instance, have a very good prognosis and their inclusion in any trial would significantly distort the conclusions.

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  1. D. Innes Williams
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© 1974 Springer-Verlag Berlin Heidelberg

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Williams, D.I. (1974). Neoplastic Disease: The Kidney. In: Urology in Childhood. Handbuch der Urologie / Encyclopedia of Urology, vol 15 / 1. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-65687-3_22

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  • DOI: https://doi.org/10.1007/978-3-642-65687-3_22

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-65689-7

  • Online ISBN: 978-3-642-65687-3

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