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Nephroblastoma
Most often occurs at the age of 5 years with equal frequency in boys and girls. The average age of male patients is 36.5 months, and for girls it is 42.5 months. Only 10% of patients are older than six years, adults get sick extremely rarely.
In the modern classification, which is also used in the Republic of Belarus, there are 5 stages of nephroblastoma (from I to V). Treatment and prognosis of the disease directly depend on the correct staging of the disease.
Treatment of nephroblastoma at the State Institution “Republican Scientific and Practical Center for Children’s Oncology, Hematology and Immunology” is carried out in accordance with the international protocol SIOP UK WT 2001. Antitumor treatment is complex and includes multicomponent chemotherapy (preoperative and postoperative), surgery, radiation therapy (for patients with unfavorable prognostic factors) and, if indicated, high-dose chemotherapy with autologous stem cell support (autologous bone marrow transplantation).
In CE, this allows achieving very good results in the treatment of nephroblastoma. Thus, the 10-year overall survival of patients with nephroblastoma in the Republic of Belarus is 88% (100% in patients with stage I, 92% with stage II, 93% with stage III, 64% with stage IV and 80% with stage V). These data are comparable with the data of the European SIOP study group. Thus, in Western Europe, the 10-year overall survival of patients with nephroblastoma was 94% for stage I, 91% for stage II, 84% for stage III and 75% for stage IV.
The surgical stage of treatment remains the most important. The scope of the operation depends on: the type of tumor growth (sometimes a multicentric tumor is encountered); unilateral or bilateral process (up to 7% of all newly diagnosed nephroblastomas); the presence of a tumor thrombus; a tumor in the wall of large vessels; tumor metastases to regional lymph nodes; distant metastases to bones, liver, lungs.
The presence of distant metastases is not a contraindication to the removal of the primary lesion. Sometimes several operations are performed.
In the period from 1998 to 2012, 201 radical operations were performed on patients with nephroblastoma at the Republican Scientific and Practical Center for Children’s Oncology, Hematology and Immunology. No local relapses were registered during the entire observation period.
Treatment of nephroblastoma in children who are citizens of the Republic of Belarus is carried out in the state institution “Republican Scientific and Practical Center for Children’s Oncology, Hematology and Immunology” regardless of the address of residence (registration) at the time of diagnosis. Treatment for citizens of the Republic of Belarus is free. The intensity of chemotherapy, the scope of surgery, indications for radiation therapy and bone marrow transplantation depend on the prevalence of the process at the time of diagnosis and the morphological features of the tumor.
Patients who do not require intensive chemotherapy can have most of their treatment done on an outpatient basis (day hospital), making the treatment more comfortable for the patient.
Foreign citizens are provided with treatment on a paid basis. The cost of nephroblastoma treatment is the cost of drugs, reagents, consumables and surgery.
The absence of a language barrier is an important advantage for CIS citizens undergoing treatment at the state institution “Republican Scientific and Practical Center for Children’s Oncology, Hematology and Immunology”.
