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Nephroblastoma

Most often occurs at the age of 5 years with the same frequency in boys and girls. The average age of patients-boys-36.5 months, girls-42.5 months. Only 10 % of patients exceed the age of six, adults are extremely rarely ill.

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 setting of the stage of the disease.

Treatment of nephroblastoma in the state institution "Republican scientific and practical center of pediatric Oncology, Hematology and immunology" is carried out in accordance with the international Protocol SIOP UK WT 2001. Antitumor treatment is complex and involves multi-component chemotherapy (preoperative and postoperative), surgery, radiation therapy (for patients with poor prognostic factors) and, if indicated, high — dose chemotherapy with autologous stem cell support (autologous bone marrow transplantation).

In CE, this allows us to achieve very good results in the treatment of nephroblastoma. Thus, the 10-year overall survival rate 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). This data is comparable to data from the European research group SIOP. Thus, in Western Europe, the 10-year overall survival rate of patients with nephroblastoma was 94% for stage I, 91% for stage II, 84% for stage III, and 75% for stage IV.

At the same time, the surgical stage of treatment remains the most important. The volume of surgery depends on: the type of tumor growth (sometimes found multicentric type of tumor); unilateral or bilateral process (up to 7% of all newly diagnosed nephroblastoma); the presence of a tumor thrombus; the tumor in the wall of large vessels; tumor metastases in regional lymph nodes; distant metastases to bones, liver, lungs.

The presence of distant metastases is not a contraindication to removing the primary focus. Sometimes several operations are performed.

During the period from 1998 to 2012, 201 radical operations were performed in patients with nephroblastoma at the Republican scientific and practical center for children's Oncology, Hematology and immunology. During the entire period of observation, no local relapse was registered.

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 of 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 of charge. The intensity of chemotherapy, the volume 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 need intensive chemotherapy can spend most of their treatment in an outpatient setting (in a day care unit), which makes treatment more comfortable for the patient.

For foreign citizens, treatment is provided on a paid basis. The cost of treating nephroblastoma is the cost of medications, reagents, supplies, and surgery.

The absence of a language barrier is an important advantage for CIS citizens who are being treated at the state institution "Republican scientific and practical center for children's Oncology, Hematology and immunology".