Staging
Staging is a process that tells a doctor if the cancer has spread, and if it has, how far. Staging is an important step in evaluating prognosis and treatment options.
Stage I
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Description
- The tumor has been surgically removed. The cancer has not yet invaded any blood vessels in the kidneys, the tumor and the kidney have not broken open, and the removed tissue has negative margins, meaning cancer cells are not found at the edges of the removed tissue.
Treatment
- Radical nephrectomy of diseased kidney, followed by chemotherapy. Children with anaplastic Wilms' tumor may receive combination chemoradiation after surgery.
Stage II
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Description
- The tumor has been surgically removed with negative margins, and:
Cancer has invaded nearby tissues outside of the kidney.
- Cancer has invaded the primary blood vessels in the kidney.
Treatment
- Radical nephrectomy of diseased kidney, followed by chemotherapy. Children with anaplastic Wilms' tumor receive radiation to the abdomen followed by chemotherapy after surgery.
Stage III
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Description
Cancer is found in the abdomen after surgery to remove the tumor and:
- Cancer has spread to pelvic or abdominal lymph nodes, OR
- Cancer has grown through the peritoneum, OR
- Patient has already undergone a surgical biopsy and chemotherapy, OR
- Tumor broke open or was removed in multiple pieces.
Treatment
- Radical nephrectomy of diseased kidney, followed by radiation therapy and chemotherapy. Some patients may be given combination chemotherapy to shrink the tumor before surgery.
Stage IV
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Description
- Cancer has spread to distant organs or distant lymph nodes, outside of the abdomen or pelvis.
Treatment
- Some patients may be given combination chemotherapy to shrink the tumor before surgery. Radical nephrectomy of affected kidney, followed by radiation therapy and chemotherapy. The surgeon may be able to surgically remove any liver metastases after radiation and chemotherapy.
Stage V
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Description
- Cancer cells are found in both kidneys at the time of diagnosis.
Treatment
- Chemotherapy and radiation therapy to shrink the tumor, followed by partial nephrectomies to both affected kidneys, followed by additional chemotherapy and possibly radiation.
