An Analysis of Treatment Failure in Wilms Tumor (WT): A Report from the Central American Association of Pediatric Hematology/Oncology (AHOPCA)

Pediatric renal tumors account for 3%-11% of childhood cancers, the most common of which is Wilms tumor or nephroblastoma. Epidemiology plays a key role in cancer prevention and control by describing the distribution of cancer and discovering risk factors for cancer. Large pediatric research consortium trials have led to a clearer understanding of pediatric renal tumors, identification of risk factors, and development of more risk-adapted therapies. These therapies have improved event-free and overall survival for children. However, several challenges remain and not all children have benefited from the improved outcomes. In this article, we review the global epidemiology of pediatric renal tumors, including key consortium and global studies. We identify current knowledge gaps and challenges facing both high and low middle-incomes countries.

Section: Resultsmentioning

confidence: 99%

Section: Wilms Tumormentioning

confidence: 99%

Pediatric renal tumor epidemiology: Global perspectives, progress, and challenges

Libes

Hol

Neto

et al. 2022

“…[63][64][65] Malnutrition and poor clinical conditions due to advanced illness are common 66 and favor a higher incidence of severe treatment-related toxicities and deaths. 63,[67][68][69] The combination of poor clinical status at the time of diagnosis, shortage of essential medicines, high cost of treatment and transportation resulting in treatment abandonment or refusal, 67,[70][71][72] low treatment compliance, and utilization of inadequately intensive treatment including omission of RT negatively impact survival. 64,70 LMICs report a higher proportion of patients with anaplasia and advanced disease, which correlate with poor prognosis.…”

Section: High-risk Wilms Tumor In Low-and Low Middle-income Countriesmentioning

confidence: 99%

Advances in the clinical management of high‐risk Wilms tumors

Ortiz

Koenig

Armstrong

et al. 2023

Self Cite

Outcomes are excellent for the majority of patients with Wilms tumors (WT). However, there remain WT subgroups for which the survival rate is approximately 50% or lower. Acknowledging that the composition of this high-risk group has changed over time reflecting improvements in therapy, we introduce the authors' view of the historical and current approach to the classification and treatment of high-risk WT. For this review, we consider high-risk WT to include patients with newly diagnosed metastatic blastemal-type or diffuse anaplastic histology, those who relapse after having been initially treated with three or more different chemotherapeutics, or those who relapse more than once. In certain low-or low middle-income settings, socio-economic factors expand the definition of what constitutes a high-risk WT. As conventional therapies are inadequate to cure the majority of high-risk WT patients, advancement of laboratory and early-phase clinical investigations to identify active agents is urgently needed.

Section: High-risk Wilms Tumor In Low-and Low Middle-income Countriesmentioning

confidence: 99%

Advances in the clinical management of high‐risk Wilms tumors

Ortiz

Koenig

Armstrong

et al. 2023

Self Cite

Outcomes are excellent for the majority of patients with Wilms tumors (WT). However, there remain WT subgroups for which the survival rate is approximately 50% or lower. Acknowledging that the composition of this high‐risk group has changed over time reflecting improvements in therapy, we introduce the authors’ view of the historical and current approach to the classification and treatment of high‐risk WT. For this review, we consider high‐risk WT to include patients with newly diagnosed metastatic blastemal‐type or diffuse anaplastic histology, those who relapse after having been initially treated with three or more different chemotherapeutics, or those who relapse more than once. In certain low‐ or low middle‐income settings, socio‐economic factors expand the definition of what constitutes a high‐risk WT. As conventional therapies are inadequate to cure the majority of high‐risk WT patients, advancement of laboratory and early‐phase clinical investigations to identify active agents is urgently needed.