Rance in 1814, but lacked details to determine the precise renal cancer. Wilms’ tumors instead get their name from a German doctor, Max Wilms, who wrote one of the first medical articles specifically about this disease in 1899. Since the turn of the twentieth century this disease has gone from being universally fatal, to having a survival rate surpassing ninety percent. This is due in large part to the development of cross sectional imaging as well as collaborative study groups focused on the management of treatment (Gleason, Lorenzo, Bowlin, & Koyle, 2014). Since the discovery of this cancer, there have been philosophies developed regarding treatment. In 1969, the National Wilms Tumor Study Group (NWTSG) was initiated to establish clinical trials and protocols in the United States, and in 2001 merged with several other groups to make up the Children’s Oncology Group (COD). This group has since become the most experienced organization in the world as far as clinical development and new therapies for children and adolescents with cancer. The Societe Internationale d’ Oncologie Pediatrique (SIOP) was also formed in 1969 with the aim to study not only Wilms’ tumors, but all types of pediatric cancers. These two groups are responsible for the two most popular protocols for treatment of Wilms’ …show more content…
The treatment of pediatric renal tumors has been improved with minimally invasive and nephron sparing approaches. Development of potential tumor markers and advancements in the delivery of chemotherapy have also increased the survival rate. As cross sectional imaging as developed, risks have been minimized by foregoing unnecessary treatments. The two most popular forms of management of the disease were developed by the SIOP and the NWTSG. The SIOP is in favor of preoperative shrinking of the tumor, leading to easier surgical removal. This procedure allows for less risk of tumor rupturing. The NWTSG choses to stage the level of the tumor and decides the procedure based on that stage. This technique reduces the occurrence of ineffective chemotherapy treatments and in some low risk groups avoids chemotherapy all together. Both groups advocate the need for adrenal sparing unless there is significant suspicion of adrenal involvement (Gleason et al.,