Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2014, vol. 23, nr 6, November-December, p. 925–931

Publication type: original article

Language: English

Clinical Factors in Relapses of Wilms’ Tumor – Results for the Polish Pediatric Solid Tumors Study Group

Ewa Niedzielska1,A,B,C,D, Krzysztof Bronowicki2,B,C, Wojciech Pietras1,A,B,C,D, Krystyna Sawicz-Birkowska3,B, Katarzyna Trybucka1,E,F, Małgorzata Rąpała2,B,C, Irena Karpińska-Derda4,B, Andrzej Kurylak5,B, Patrycja Marciniak-Stępak6,B, Anna Panasiuk7,B, Joanna Nurzyńska-Flak8,B, Jarosław Peregud-Pogorzelski9,B, Danuta Pietrys10,B, Iwona Rurańska11,B, Grażyna Sobol12,B, Joanna Stefanowicz13,B, Sabina Szymik-Kantorowicz14,B, Małgorzata Zubowska15,B, Jan Godziński16,17,E,F

1 Department and Clinic of Pediatric Oncology, Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Poland

2 Department of Pediatric Surgery, Marciniak Hospital, Wrocław, Poland

3 Department and Clinic of Pediatric Surgery and Urology, Wroclaw Medical University, Poland

4 Department of Pediatric Hematology and Oncology, Chorzow Pediatrics and Oncology Center, Poland

5 Department of Pediatrics, Hematology and Oncology, Nicolaus Copernicus University, Bydgoszcz, Poland

6 Department of Pediatric Oncology, Hematology and Transplantology, Medical University of Poznań, Poland

7 Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Poland

8 Department of Pediatric Oncology and Hematology, Medical University of Lublin, Poland

9 Department of Oncology and Hematology, Pomeranian Medical University in Szczecin, Poland

10 Department of Pediatric Hematology and Oncology, Children’s University Hospital, Kraków, Poland

11 Department of Pediatric Hematology and Oncology, Medical University of Silesia, Zabrze, Poland

12 Department of Pediatric Oncology, Hematology and Chemotherapy, Medical University of Silesia, Katowice, Poland

13 Clinic of Pediatrics, Hematology, Oncology and Endocrinology, Medical University of Gdańsk, Poland

14 Clinic of Pediatric Surgery, Polish-American Institute of Pediatrics, Jagiellonian University Medical College, Kraków, Poland

15 Clinic of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Poland

16 Department of Emergency Medicine, Wroclaw Medical University, Poland

Abstract

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).
Conclusion. 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.

Key words

nephroblastoma, risk factors, Wilms’ tumor, relapse.

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