hematogenous metastasis

Lymphogenous or hematogenous metastases.

In stage IV Wilms tumor (11% of patients), hematogenous metastases (lung, liver, bone, brain), or lymph node metastases outside the abdominopelvic region are present.

Patients with LD are treated with chemotherapy and thoracic radiation, whereas, for the most part, patients with ED (distant hematogenous metastases) receive only chemotherapy.

Patients with pleural effusion have an intermediate prognosis between LD and ED with hematogenous metastases and will be classified as having M1 disease (or ED).