Which of the following malignant disease of children has the best prognosis?
Ans. is 'a' i.e. Wilms' tumour Ref: C.P.D.T 16th/e page 807-809, 811 Schwartz Surgery page 1748, 1749, 1747Prognosis depends most importantly upon staging but there are multiple factors affecting the prognosisAfter going through the survival rates of these tumours and confirming our answer with a paediatric oncologist we found the Wilms' tumor to have the best prognosis among the given options.If you have time go through the below given tables for your own satisfaction and conclusions.Wilms' tumour: CSDT 11th/e p 1345Stage4 year Survival % Favorable histologyUnfavorable histologyLimited to kidney9789Extends beyond kidney9468Residual tumor confined to abdomen8868Distant metastasis8255Bilateral renal involvement8416* Prognosis of Rhabdomyosarcoma: CPDT 15th/e p 812Site3 year disease free survivalPredominant Pathologic subtypeHead & Neck EmbryonalOrbit93% Parameningeal71% Other69% Genitourinary Embryonal (botryoid variant in bladder and vagina)Bladder and prostate64-80% Vagina and uterus60-80% Paratesticular60-80% Extremities56%Alveolar (50%) undifferentiatedTrunk57%Alveolar undifferentiated* Neuroblastoma: CSDT 11th/e p 1343Staging and survival of NeuroblastomaSurvivalI. Tumor confined to site of origin100%Ila. Unilateral tumour completely excised. Nodes Negative80%lIb. Unilateral tumour; complete or incomplete excision nodes positive70%.III. Tumor infiltrating across the midline, or a unilateral tumor with contralateral40%nodes positive IV. Remote disease in bone, soft tissue, distant nodes15%V. Infants with stage I or stage II primary and spread to Liver skin or bone marrow.85%Primitive neuroectodermal tumours -PETs includeMedulloepitheliomaMedulloblastoma (known as PET-MB)Primary cerebral neuroblastomaPineoblastomaEpendymoblastomaPrognosis: 5 year survival rate is near about 75% after total tumor removal.
Wilm's tumor
Neuroblastoma
Rhabdomyosarcoma
Primitive neuroectodermal tumor
Renal Tumors