Author:
Zekri Wael,Yacoub Dalia M.,Ibrahim Asmaa,Madney Youssef
Abstract
Abstract
Background
Wilms’ tumor (WT) affects one in 10,000 children and accounts for 5% of all childhood cancers. Although the overall relapse rate for children with WT has decreased to less than 15 %, the overall survival for patients with recurrent disease remains poor at approximately 50 %. The aim of the study to evaluate the outcome of relapsed Wilms’ tumor pediatric patients treated at the National Cancer Institute (NCI), Egypt, between January 2008 and December 2015.
Results
One hundred thirty (130) patients diagnosed with WT during the study period, thirty (23%) patients had relapsed. The median follow up period was 22.3 months (range 3.6–140 months). The Overall Survival (OS) was 30.9% while the event-free survival (EFS) was 29.8% at a 5-year follow up period. Median time from diagnosis to relapse was 14.4 months. A second complete remission was attained in 18/30 patients (60%). The outcome of the 30 patients; 11 are alive and 19 had died. Three factors in our univariate analysis were prognostically significant for survival after relapse. The first was radiotherapy given after relapse (p = 0.012). The 5-year EFS and OS for the group that received radiotherapy were 41.9% versus 16.7% and 11.1% respectively for those that did not. The second was the state of lymph nodes among patients with local stage III (p = 0.004). Lastly, when risk stratification has been applied retrospectively on our study group, it proved to be statistically significant (p = 0.029).
Conclusion
Among relapsed pediatric WT, radiotherapy improved survival at the time of relapse and local stage III with positive lymph nodes had the worst survival among other stage III patients.
Publisher
Springer Science and Business Media LLC
Reference25 articles.
1. Szychot E, Apps J, Pritchard-Jones K, et al. Wilms’ tumor: biology, diagnosis and treatment. Transl Pediatr. 2014.
2. D’Angio GJ, Evans A, Breslow N, Beckwith B, Bishop H, Farewell V, Goodwin W, Leape L, Palmer N, Sinks L, Sutow W, Tefft M, Wolff J. The treatment of Wilms’ tumor: results of the second national Wilms’ tumor study. Cancer. 1981.
3. Grundy P, Breslow N, Green DM, Sharples K, Evans A, D’Angio GJ. Prognostic factors for children with recurrent Wilms’ tumor: results from the second and third national Wilms’ tumor study. J Clin Oncol. 1989.
4. Pinkerton CR, Groot-Loonen JJ, Morris-Jones PH, Pritchard J. Response rates in relapsed wilms’ tumor. A need for new effective agents. Cancer. 1991.
5. Sarin YK, Graf N. Management of recurrent Wilms’ tumor. J Int Med Sci Acad. 2014.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献