الفهرس 
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Abstract
Background: Wilms’ tumor (WT) is the most common renal malignant tumor of childhood. Metastatic WT has a worse prognosis than localized disease. Timing and type of surgery together with type of chemotherapy (CTH) regimen, administration of radiotherapy (RT) or not as well as the site of irradiation, depend on many factors, including histologic type of the tumor, site of metastases, local stage and response of pulmonary nodules to neo-adjuvant CTH. Purpose: To assess the clinical outcome and the different prognostic factors that might influence the outcome of pediatric metastatic WT cases at initial presentation treated at National Cancer Institute (NCI), Cairo University, Egypt. Methods: This is a retrospective study included pediatric stage IV WT patients presented to NCI, between January 2008 and December 2015. Medical records of all patients were reviewed for demographic profile, clinical features, imaging studies, treatment and outcome. Patients were treated according to modified COG protocol ”AREN0533” and were followed up till December 2017