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Clinical factors in relapses of Wilms' tumor--results for the Polish Pediatric Solid Tumors Study Group
Ewa Niedzielska1, Krzysztof Bronowicki2, Wojciech Pietras1
1Department and Clinic of Pediatric Oncology, Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Poland.
Insights
Wilms tumor recurrences are influenced by pathology, not age or gender. Relapse prognosis is similar for metastatic and localized initial disease, with pathology variants being key factors.
Area of Science:
- Pediatric Oncology
- Cancer Research
- Clinical Pathology
Background:
- Wilms tumor (nephroblastoma) recurrence risk factors are debated.
- Understanding these factors is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the relationship between Wilms tumor relapses and patient clinical history.
- To identify significant predictors of recurrence in pediatric cancer patients.
Main Methods:
- Analysis of clinical data from children treated under SIOP 2001 protocols.
- Correlation of clinical stages (CS), pathology variants (high risk: HR, intermediate risk: INT, low risk: LOW), and chemotherapy with outcomes.
- Statistical analysis of age, gender, and recurrence risk.
Main Results:
- 11.8% (34/288) of patients experienced recurrences.
- Recurrence risk was not correlated with age or gender.
- Pathology variants, particularly intermediate and high risk, were associated with second recurrences and disease progression.
Conclusions:
- Prognosis after relapse is similar for initially metastatic and localized Wilms tumor.
- Pathology variants appear to be more significant predictors of recurrence and outcome than initial disease presentation.
Background:
The risk factors responsible for recurrences of Wilms' tumor (nephroblastoma) are still under discussion. The aim of the study was to analyze the relationship between relapses of Wilms' tumor and the patients' clinical history.
Material And Methods:
Clinical data from children registered in the Polish Pediatric Solid Tumors Study Group were analyzed. The clinical stages (CS), pathology variants (high risk: HR, intermediate risk: INT, and low risk: LOW) and chemotherapy regimens were correlated with the outcomes.
Results:
Recurrences developed in 34 out of 288 (11.8%) patients with Wilms' tumor treated in accordance with International Society for Pediatric Oncology 2001 (SIOP 2001) protocols. Of these 34 patients, 11 initially had CS I, seven were at CS II, four were at CS III, 11 were at CS IV and one had CS V. There were eight patients with second recurrences; of these, seven were in the INT risk group and one in the high histological risk group. There was no correlation between age (p=0.256) or gender (p=0.538) and the risk of tumor recurrence. In the study group, seven out of 10 patients with local recurrences are alive; as are 13 out of 22 patients with distant recurrences (p=0.703). Those who died due to disease progression comprised six out of 26 patients with a first recurrence (four HR, two INT), and seven out of eight with a second recurrence (one HR, six INT).
Conclusions:
The prognosis after relapse in initially metastatic patients did not differ from that in patients who had primarily localized disease. The pathology variants probably had more significance.
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