This case report details the treatment of a 3-year-old girl diagnosed with bilateral Wilms tumor and a TP53 mutation. She received neoadjuvant chemotherapy using vincristine, actinomycin D, and doxorubicin. This was followed by staged bilateral nephron-sparing surgery and postoperative targeted oral therapy. The patient also underwent multiple chemotherapy regimens and radiotherapy according to the Chinese Children Cancer Group protocol.
Despite this intensive approach, the disease progressed. The tumor advanced to end-stage disease, and the patient died. No adverse events or discontinuations were reported in this specific case.
The main reason to be careful is that this evidence comes from a single case. The limitations of current histology- and stage-based approaches for specific molecular subtypes are noted. Current evidence supports more aggressive surgical intervention for high-risk cases, but it is essential to balance the need for renal function preservation with the goal of achieving oncological control. Readers should not infer survival rates or event rates from a single case report.