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What is The most impoant determinant of prognosis in Wilms tumor and explain in detail?
The most impoant prognostic factors in Wilms tumor is its histopathology.3% of tumors show ourable pathology(focal anaplasia)for which only surgical excision is needed.Another 6% have unourable pathology(diffuse analplasia);these tumors are pleomorphic and ruptured and show early metastasis to bones. Other prognostic factors are Stage of the disease,Ploidy(diploid tumors have better prognosis than hyperdiploid tumors).Young age,low stage and low tumor weight(<550 g) are ourable prognostic factors.Presence of anaplasia and loss of heterozygosity of 1p or 16q increase risk recurrence. Reference:Essential pediatrics-Ghai,8th edition,page no:618