Background: We conducted a retrospective analysis to investigate the clinical
outcome of combined modality therapy using multiagent chemotherapy, nephrectomy,
and radiotherapy in treatment of children with Wilms' tumor.
Methods: This study was conducted on 91 cases of newly diagnosed Wilms' tumor
from January 2001 until February 2012. Patients were categorized into two groups
according to treatment approach: i) preoperative chemotherapy with delayed surgery
(group A; n=66) and ii) immediate surgery (group B; n=25).
Results: Preoperative chemotherapy showed a 54.5% partial response rate in
group A patients. A final stage distribution indicated that the majority of patients
(64%) from both groups were considered to be in the early disease stages (I and II).
The median follow up was 49 months (range 3-124). The five-year overall survival rate
was 66.5%, whereas the event-free survival rate was 62.5%. In univariate analysis, factors
associated with statistically significant reduction in overall (P<0.0001) and event-free
survival (P=0.0001) rates included advanced disease stages (P<0.0001 for both) and
blastimal subtype (P=0.0067 for overall survival; P=0.012 for event-free survival). Age
of >24 months was associated with a significant reduction in the overall survival rate
(P=0.038, HR: 0.438, 95% CI: 0.192-0.953), but was not significant in terms of eventfree
survival (P=0.104, HR: 0.539, 95% CI: 0.256-1.136). Age >24 months (P=0.0095),
disease stage (P=0.0014), and blastimal subtype (P=0.006) were associated with
significant increases in relapse rate.
Conclusion: Preoperative chemotherapy resulted in a final stage redistribution that
placed the majority of patients in the early stages of the disease. Age at diagnosis, disease
stage, and histological subtype significantly affected survival and relapse rates.
Research Member
Research Department
Research Year
2012
Research Journal
Middle East Journal of Cancer
Research Vol
vol.3. No.4
Research Rank
1
Research_Pages
PP131-140.
Research Abstract