Advances in Clinical and Experimental Medicine
2014, vol. 23, nr 6, November-December, p. 925–931
Publication type: original article
Clinical Factors in Relapses of Wilms’ Tumor – Results for the Polish Pediatric Solid Tumors Study Group
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
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.
nephroblastoma, risk factors, Wilms’ tumor, relapse.
- Green DM: The evolution of treatent for Wilms’ tumor. J Pediatr Surg 2013, 48, 14–19.
- Pietras W: Advances and changes in the treatment of children with nephroblastoma. Adv Clin Exp Med 2012, 21, 809–820.
- The clinical trial, SIOP (International Society of Paediatric Oncology) WT 2001.
- Breslow NE, Palmer NF, Hill LR, Buring J, D’Angio GJ: Wilms’ tumor: prognostic factors for patients without metastases at diagnosis: results of the National Wilms’ Tumor Study. Cancer 1978, 41, 1577–1589.
- Breslow N, Churchill G, Beckwith JB, Fernbach DJ, Otherson HB, Tefft M, D’Angio GJ: Prognosis for Wilms’ tumor patients with nonmetastatic disease at diagnosis – results of the second National Wilms’ Tumor Study. J Clin Oncol 1985, 3, 521–531.
- Breslow N, Sharples K, Beckwith JB, Takashima J, Kelalis PP, Green DM, D’Angio GJ: Prognostic factors in nonmetastatic, favorable histology Wilms’ tumor. Results of the Third National Wilms’ Tumor Study. Cancer 1991, 68, 2345–2353.
- Shamberger RC, Guthrie KA, Ritchey ML, Haase GM, Takashima J, Beckwith JB, D’Angio GJ, Green DM, Breslow NE: Surgery-related factors and local recurrence of Wilms’ tumor in National Wilms’ Tumor Study 4. Ann Surg 1999, 229, 292–297.
- Weirich A, Ludwig R, Graf N, Abel U, Leuschner I, Vujanic GM, Mehls O, Boos J, Beck J, Royer-Pokora B, Voûte PA: Survival in nephroblastoma treated according to the trial and study SIOP-9/GPOH with respect to relapse and morbidity. Ann Oncol 2004, 15, 808–820.
- Pritchard-Jones K, Kelsey A, Vujanic G Imeson J, Hutton C, Mitchell C: Older age is an adverse prognostic factor in stage I, favorable histology Wilms’ tumor treated with vincristine monochemotherapy: a study by the United Kingdom Children’s Cancer Study Group, Wilm’s Tumor Working Group. J Clin Oncol 2003, 21, 3269–3275.
- Reinhard H, Schmidt A, Furtwängler R, Leuschner I, Rübe C, Von Schweinitz D, Zoubek A, Niggli F, Graf N: Outcome of relapse of nephroblastoma in patients registered in the SIOP/GPOH trails and studies. Oncol Rep 2008, 20, 463–467.
- Kaste SC, Dome JS, Babyn PS, Graf NM, Grundy P, Godzinski J, Levitt GA, Jenkinson H: Wilms’ tumour: prognostic factors, staging, therapy and late effects. Pediatr Radiol 2008, 38, 2–17.
- Dome JS, Liu T, Krasin M, Lott L, Shearer P, Daw NC, Billups CA, Wilimas JA: Improved survival for patients with recurrent Wilms’ tumor: the experience at St. Jude Children’s Research Hospital. J Pediatr Hematol Oncol 2002, 24, 192–198.
- Abu-Ghosh AM, Krailo MD, Goldman SC, Slack RS, Davenport V, Morris E, Laver JH, Reaman GH, Cairo MS: Ifosfamide, carboplatin and etoposide in children with poor-risk relapsed Wilms’ tumor: a Children’s Cancer Group report. Ann Oncol 2002, 13, 460.
- Campbell AD, Cohn SL, Reynolds M, Seshadri R, Morgan E, Geissler G, Rademaker A, Marymount M, Kalapurakal J, Haut PR, Duerst R, Kletzel M: Treatment of relapsed Wilms’ tumor with high-dose therapy and autologous hematopoietic stem-cell rescue: the experience at. Children’s Memorial Hospital. J Clin Oncol 2004, 22, 2885–2890.
- Dallorso S, Dini G, Faraci M, Spreafico F: EBMT Paediatric Working Party: SCT for Wilms’ tumour. Bone Marrow Transplant 2008, 41, Suppl 2, S128–130.
- Ha TC, Spreafico F, Graf N, Dallorso S, Dome JS, Malogolowkin M, Furtwängler R, Hale JP, Moroz V, Machin D, Pritchard-Jones K: An international strategy to determine the role of high dose therapy in recurrent Wilms’ tumour. Eur J Cancer 2013, 49, 194–210.
- Furtwängler R, Nourkami N, Alkassar M, von Schweinitz D, Schenk JP, Rübe C, Siemer S, Leuschner I, Graf N: Update on relapses in unilateral nephroblastoma registered in 3 consecutive SIOP/GPOH studies – a report from the GPOH-nephroblastoma study group. Klin Padiatr 2011, 223, 113–119.
- Klamt B, Schulze M, Thate C, Mares J, Goetz P, Kodet R, Scheulen W, Weirich A, Graf N, Gessler M: Allele loss in Wilms’ tumors of chromosome arms 11q, 16q, and 22q correlate with clinicopathological parameters. Genes Chromosomes Cancer 1998, 22, 287–294.
- Bown N, Cotterill SJ, Roberts P, Griffiths M, Larkins S, Hibbert S, Middleton H, Kelsey A, Tritton D, Mitchell C: Cytogenetic abnormalities and clinical outcome inWilms’ tumor: a study by the U.K. cancer cytogenetics group and the U.K. Children’s Cancer Study Group. Med Pediatr Oncol 2002, 38, 11–21.
- Grundy PE, Breslow NE, Li S, Perlman E, Beckwith JB, Ritchey ML, Shamberger RC, Haase GM, D’Angio GJ, Donaldson M, Coppes MJ, Malogolowkin M, Shearer P, Thomas PR, Macklis R, Tomlinson G, Huff V, Green DM: National Wilms’ Tumor Study Group: Loss of heterozygosity for chromosomes 1p and 16q is an adverse prognostic factor in favorable-histology Wilms’ tumor: a report from the National Wilms’ Tumor Study Group. J Clin Oncol 2005, 23, 7312–7321.
- Li W, Kessler P, Yeger H, Alami J, Reeve AE, Heathcott R, Skeen J, Williams BR: A Gene Expression Signature for Relapse of Primary Wilms’ Tumors. Cancer Res 2005, 65, 2592–2601.
- Routh JC, Ashley RA, Sebo TJ, Lohse CM, Husmann DA, Kramer SA, Kwon ED: B7-H1 expression in Wilms’ tumor: correlation with tumor biology and disease recurrence. J Urol 2008, 179, 1954–1960.