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The overall prognosis of Wilms Tumor usually quite positive with more than 80% of all children diagnosed expecting to survive the disease long-term. With a timely diagnosis before the tumor has metastasized to other parts of the body the cure rate is even higher at 90% with standard treatment.
The specific prognosis for each individual affected by this disease depends on the stage of the disease and the treatment plan. It is important that the tumor is removed as early as possible and appropriate management is undertaken, to reduce the risk of spreading.
One of the most important categorizations that can help to estimate prognosis is the histology of the cancer cells, based on the microscopic appearance.
Cells with favorable histology account for the majority of Wilms tumor cases and involve cancer cells that display abnormal characteristics but do not have large defects in the genetic DNA. This type is associated with a positive prognosis, often more than 90% depending on the progression of the tumor.
Unfavorable histology is marked by cancer cells with wide variations in appearance with the nucleus of the cell usually appearing swollen and distorted. This effect is known as anaplasia and is more difficult to treat and hence associated with a poorer prognosis.
Loss-of-heterozygosity (LOH) of chromosomes 1p and 16q in particular tumor cells are a specific class of Wilms tumor cases. Patients affected by this pathology of the disease are associated with a higher risk of relapse or death and, therefore, this factor can be used to help determine prognosis and choose appropriate treatment strengths.
Cancerous tumors are classified according to five stages, each of which is associated with a different prognosis according to the disease progression.
Even though the overall prognosis of Wilms tumor is quite promising, children that are affected by the disease are at an increased risk of second cancer later in life. This is thought to be as a result of exposure to treatment in the management of Wilms tumor, although the benefits of treatment continue to outweigh these risks.
Second tumors that people that have been affected by Wilms tumor are more susceptible to include bone and soft-tissue sarcomas, breast cancer, lymphoma, melanoma, leukemia and cancer of the breast or gastrointestinal tract.