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The outcome of Wilms' tumor in infants. Italy 1970-79
Insights
Wilms' tumor survival rates in infants vary by tumor stage, with earlier stages showing higher survival. Treatment including surgery and chemotherapy offers similar survival to adding radiotherapy for early-stage Wilms' tumor.
Area of Science:
- Pediatric Oncology
- Pediatric Surgery
- Pediatric Chemotherapy
Background:
- Wilms' tumor is a common kidney cancer in children.
- Treatment protocols have evolved over time.
- Understanding survival rates based on tumor stage and treatment is crucial.
Purpose of the Study:
- To analyze survival rates of infants with Wilms' tumor based on tumor stage and treatment modalities.
- To evaluate the impact of radiotherapy on survival for different stages of Wilms' tumor.
Main Methods:
- Retrospective analysis of 34 infants diagnosed with Wilms' tumor between 1970-1979.
- Data collected from 14 Italian pediatric oncology units.
- Survival rates were stratified by tumor group (I, II, III) and treatment (surgery, chemotherapy, radiotherapy).
Main Results:
- Three-year survival rates decreased significantly with increasing tumor stage: 95% (Group I), 75% (Group II), and 20% (Group III).
- Survival rates for Group I and II Wilms' tumor were comparable between patients treated with surgery and chemotherapy versus those who also received radiotherapy.
- A decrease in radiotherapy use for Group I tumors was observed in the later period (1975-79) compared to the earlier period (1970-74).
Conclusions:
- Tumor stage is a critical determinant of survival in infant Wilms' tumor.
- For early-stage Wilms' tumor (Group I and II), combined surgery and chemotherapy yield comparable survival to adding postoperative radiotherapy.
- The trend suggests a potential de-escalation of radiotherapy for early-stage Wilms' tumor over time.
Abstract:
Thirty-four infants under 1 year of age with Wilms' tumor were diagnosed and treated in 14 Italian pediatric oncology units during 1970-79. The 3-year survival rates decreased with higher group unilateral tumors: 95% in group I Wilms' tumor, 75% in group II and 20% in group III. The survival rates for children with group I and II Wilms' tumor were similar for those who were treated with surgery and chemotherapy and those who also received postoperative radiotherapy. During 1975-79 fewer patients with group I Wilms' tumor received radiotherapy (1 of 11) than during 1970-74 (4 of 6, p less than 0.05). All these children are alive at this writing.