Survival in bilateral metachronous (asynchronous) Wilms tumors

Area of Science:

• Pediatric Oncology
• Nephrology
• Cancer Research

Background:

• Wilms tumor survival rates have dramatically increased over recent decades.
• Bilateral Wilms tumors, particularly metachronous cases, are often associated with a poorer prognosis.
• Significant advancements in treatment have been made for unilateral Wilms tumors.

Purpose of the Study:

• To evaluate the current survival outcomes for patients diagnosed with metachronous Wilms tumors.
• To compare the prognosis of metachronous Wilms tumors with unilateral and bilateral synchronous Wilms tumors.
• To assess the impact of tumor spread on survival rates in different Wilms tumor presentations.

Main Methods:

• Retrospective review of 50 metachronous Wilms tumor cases reported over the past 20 years.
• Analysis of survival data stratified by tumor presentation (unilateral, bilateral synchronous, metachronous).
• Matching cases based on the extent of tumor spread for comparative survival analysis.

Main Results:

• Survival for metachronous Wilms tumors has improved substantially over the last two decades.
• The survival trends for metachronous Wilms tumors mirror those of unilateral Wilms tumors.
• When adjusted for tumor spread, survival rates from the last decade for metachronous cases are nearly identical to those of bilateral synchronous and unilateral Wilms tumors.

Conclusions:

• Metachronous Wilms tumors no longer carry a significantly worse prognosis compared to unilateral disease.
• Treatment advancements have led to comparable survival outcomes across different Wilms tumor subtypes when stage is considered.
• The findings support a more optimistic outlook for patients with metachronous Wilms tumors.