Old approach: If relapse occurs, use ICE (ifosfamide-carboplatin-etoposide) – still backbone.
But NEW additions:
One key slide: Algorithm for first relapse (early vs late, anaplastic vs favorable). wilms tumor ppt new
Include a 2-minute case to engage your audience: One key slide: Algorithm for first relapse (early
3-year-old girl with right renal mass. CT shows tumor thrombus in IVC below diaphragm. No metastases. Biopsy shows favorable histology. Molecular panel: 1q gain. How do you treat? Other features: nephrogenic rests (precursor lesions) may be
Answer per new guidelines: Stage III (tumor thrombus) + molecular high-risk → intensify to Regimen DD-4A + flank radiation (19.8 Gy) despite favorable histology.
Minimally invasive surgery (MIS): Laparoscopic nephrectomy for Stage I tumors (<500g, no IVC thrombus) is now acceptable in selected centers (new data 2024 shows equivalent outcomes).