Saltzman AF, et al. - The National Cancer Database was questioned for persons with Wilms tumor (WT) diagnosis from 2004-2013 in order to explain and contrast the management of WT and oncologic outcomes by patient age using a large national database. The majority of persons were children (n = 2,686), followed by young adult (n = 91), and adult (n = 35). For children vs young adults or adults, 5-year OS and 10-year OS were significantly better. On multivariate analysis, OS was markedly better for children compared with young adults, and adults. Other variables related to worse OS were bilateral disease, stage II disease, stage IV disease, and positive lymph nodes. Individuals > 15 years were less inclined to undergo lymph node sampling, radiation therapy, or chemotherapy. Therefore, adults with WT encounter worse 5- and 10-year OS when contrasted with children with WT. Moreover, survival decrements in adults are possible multifactorial including modifiable factors like ineffectual staging because of low rates of lymph node sampling, and under-utilization of adjuvant therapies.