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Relapsed Wilms Tumor Management and Outcomes in Canada: A Report From CYP-C
Amy D Lu1, Conrad V Fernandez2, Rodrigo L P Romao2
1Department of Paediatrics, Hospital for Sick Children.
Journal of Pediatric Hematology/Oncology
|October 13, 2025
Summary
In pediatric Wilms tumor (WT) relapse, surgery as part of multimodal therapy may improve survival. Further research is needed to confirm the benefit of surgical intervention in relapsed WT patients.
Area of Science:
- Pediatric Oncology
- Nephrology
- Surgical Oncology
Background:
- Wilms tumor (WT) is the most common pediatric kidney cancer, with up to 15% of patients experiencing relapse.
- Management of relapsed WT is not well-defined, necessitating studies on optimal therapeutic strategies.
Purpose of the Study:
- To describe the Canadian experience with relapsed Wilms tumor.
- To evaluate the impact of surgical intervention on survival outcomes in relapsed WT patients.
Main Methods:
- A population-based cohort of relapsed WT patients (2001-2020) was identified from the Cancer in Young People in Canada program.
- Kaplan-Meier methods estimated 4-year event-free survival (EFS) and overall survival (OS).
- Cox proportional hazards models assessed the effect of surgery on EFS/OS, adjusting for chemotherapy regimen.
Main Results:
- Ninety-seven patients with relapsed WT were analyzed; median age at relapse was 5.2 years.
- Four-year EFS was 54.0% and OS was 61.6%.
- Surgical intervention was associated with improved OS (HR 0.36, P=.003) and a trend towards improved EFS (HR 0.54, P=.06).
Conclusions:
- Canadian outcomes for relapsed WT compare favorably with international data.
- Patients undergoing surgical intervention at relapse showed more favorable survival.
- The potential therapeutic benefit of resection requires further investigation, considering confounding factors like disease extent and treatment response.
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