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Childhood renal tumor: a report from a Chinese Children's Cancer Group
Jiaoyang Cai1, Ci Pan1, Qin Lu2
1Key Laboratory of Pediatric Hematology & Oncology Ministry of Health, Department of Pediatric Hematology and Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, China.
Insights
Multicenter cooperative groups in China show feasibility for treating childhood renal tumors. Radiation therapy significantly improves survival for advanced stages but faces implementation challenges.
Area of Science:
- Pediatric Oncology
- Clinical Trial Research
- Cancer Treatment Modalities
Background:
- Childhood renal tumors require effective treatment strategies.
- Establishing cooperative treatment groups is crucial for managing rare pediatric cancers.
- Radiotherapy plays a role in treating specific stages of renal tumors.
Purpose of the Study:
- To evaluate the establishment and outcomes of multicenter cooperative treatment groups for childhood renal tumors in China.
- To assess radiotherapy compliance and effectiveness in this patient cohort.
- To analyze survival rates based on histology and tumor stage.
Main Methods:
- Retrospective review of medical records for 316 children with renal tumors.
- Data collected from 14 hospitals within a multicenter cooperative group (1998-2012).
- Analysis of event-free survival rates, stratified by histology, stage, and radiotherapy use.
Main Results:
- Overall five-year event-free survival was 72%.
- Favorable histology showed 76.1% survival; unfavorable histology had 59%.
- Patients receiving indicated radiotherapy (95) had 72.8% survival versus 24% for those not receiving it (58).
Conclusions:
- The multicenter cooperative group model is feasible for childhood renal tumor treatment in China.
- Radiotherapy is vital for Stages III and IV but faces implementation difficulties.
- Attention from government and medical professionals is needed to improve radiotherapy access and outcomes.
Abstract:
Here we investigated the establishment of multicenter cooperative treatment groups in China, as well as radiotherapy compliance and effectiveness among children with renal tumors. Medical records were reviewed for 316 children with renal tumors diagnosed by a multicenter cooperative group from 14 hospitals in China from 1998 to 2012. Median patient age was 29.5 months (range, 2-173 months old), and male-to-female ratio was 1.4 : 1. After a median follow-up of 22 months (range, 1-177 months), five-year event-free survival rates were 72% overall; 76.1% for favorable histology (251 cases); 59% for unfavorable histology (27 cases); and 91%, 75%, 71%, 53%, and 48.5%, respectively for Stages I, II, III, IV, and V. Following standardized criteria, radiation therapy was indicated for 153 patients, among whom five-year event-free survival was 72.8% for the 95 who received radiation and 24% for the 58 patients who did not. Our results are reasonable but can be further improved and show the feasibility of a multicenter cooperative group model for childhood renal tumor treatment in China. Radiation therapy is important for stage III and IV patients but remains difficult to implement in some parts of China. Government management departments and medical professionals must pay attention to this situation. This clinical trial is registered with ChiCTR-PRCH-14004372.