• Takeshi Aoba, Naoto Urushihara, Koji Fukumoto, Shigeyuki Furuta, Hiroaki Fukuzawa, Maki Mitsunaga, Kentaro Watanabe, Masaya Yamoto, Hiromu Miyake, Mariko Koyama, Hideto Iwabuchi, Junki Koike, Shinobu Tatsunami, Munechika Wakisaka, and Hiroaki Kitagawa.
• Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan. t2aoba@marianna-u.ac.jp
• J. Pediatr. Surg. 2012 Dec 1; 47 (12): 2210-5.

PurposeTo evaluate the clinicopathological features that indicate relapse and suggest a new risk based therapeutic strategy for unilateral Favorable Histology Wilms Tumor (FH-WT).Materials & MethodsThirty-three patients with unilateral WT were treated in two institutions between 1986 and 2010. Twenty-eight patients with FH-WT received primary nephrectomy according to the National Wilms' Tumor Study (NWTS) or the Japanese Wilms' Tumor Study (JWiTS) protocol. Retrospective analyses of the non-relapsed group (n=23) and the relapsed group (n=5) compared age, gender, tumor laterality, tumor weight, initial tumor stage, known histological subtype, chemotherapy (2 or 3 drugs), and any irradiation delivered. Stages and histological subtypes of the tumors were re-evaluated according to the Japanese staging system.ResultsFive of the twenty-eight tumors relapsed, and one patient died. The initial staging (P=0.029) and the histological subtype (P=0.003) were the only factors indicating relapse. Nine of the twenty-three tumors were histologically classified as blastemal predominant subtype (BPT-WT). Five relapsed.ConclusionAccording to the basic Japanese therapeutic strategy, all patients underwent a primary nephrectomy before chemotherapy. This study suggests that the histological subtype pre-treatment "BPT-WT" should be included as a strong indicator of poor prognosis. Such patients should be treated as a high-risk group.Copyright © 2012 Elsevier Inc. All rights reserved.

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