A histologic classification based on tumor differentiation, degree of tubular formation and favor-able histology versus unfavorable histology was applied in a retrospective study of 21 patients with Wilms tumor to determine if it might provide an index to prognosis from 1977 through 1987.
A comparison of the histologic findings with survival through statistical analysis was undertaken and it was found that the histologic classification was significantly correlated with survival.
The results were as follows:
1. Low grade tumors(grade I) with predominance of differwtiated tubules & glomeruli were associated with better survival rate than high grade tumors(grade Ⅲ) composed mainly of undifferentiated spindle elements: 2-year survival rate was 100% for grade I with 11% for grade Ⅲ (p<0.01).
2. Survival rate was lower for the low degree of tubular formation than for the high degree of tubular formation: 2-year survival rate were 10o´, 50%, 75%, 100% for group 0, +, ++, and +++ respectively(p < 0.05).
3. 11 patients with the focal or diffuse anaplasia and sarcomatous stroma (unfavorable histology) had poor prognosis, giving 36% of 2-year survival rate but 10 patients with favorable histology had 70% of 2-year survival rate (p<0.05).
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