Prognostic factors in nonmetastatic, favorable histology wilms' tumor. Results of the third national wilms' tumor study

Breslow, Norman E.; Sharples, Katrina; Beckwith, J. Bruce; Takashima, Janice R.; Kelalis, Panayotis P.; Green, Daniel M.; D’Angio, Giulio J.

doi:10.1002/1097-0142(19911201)68:11<2345::aid-cncr2820681103>3.0.co;2-t

Cited by 133 publications

(94 citation statements)

References 16 publications

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“…Cooperative studies have shown that increasing age is associated with an increased risk of recurrence of nonmetastatic WT (6,7,(9)(10)(11). This is only partly explained by the fact that the occurrence of anaplasia increases with age (12); even in patients with favorable histology, older age seems to be associated with less favorable outcome.…”

Section: Generalsupporting

confidence: 80%

The Clinical Relevance of Age at Presentation in Nephroblastoma

et al. 2016

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Licence: This open access article is licensed under Creative Commons Attribution 4.0 International (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Users are allowed to share (copy and redistribute the material in any medium or format) and adapt (remix, transform, and build upon the material for any purpose, even commercially), as long as the authors and the publisher are explicitly identified and properly acknowledged as the original source. AbstractThe most important prognostic factors for Wilms tumor (WT) patients seem to be stage, histological subtype, and 1p/16q loss of heterozygosity (LOH) in chemotherapy-naive WTs. 24Over the last decade, age at diagnosis also was suggested to be an important risk factor for WT recurrence in Children's Oncology Group (COG), United Kingdom (UK), and International Society of Pediatric Oncology (SIOP) studies. Several studies have analyzed age as a prognostic factor; these studies revealed age <2 years as a favorable prognostic factor, while age >4 years has been described as an adverse prognostic factor. In adults (>18 years of age), WT represents less than 1% of all diagnosed renal tumors; therefore, diagnosis of WT in adults is often unexpected and poorly recognized, thereby inducing treatment delay with subsequent adverse outcome. One explanation for the higher risk of recurrence with increasing patient age is the higher frequency of anaplasia at higher age. Other suggested reasons are delay in diagnosis, advanced tumor stage at presentation, and intrinsically different biological behaviors. Whether age is really an independent risk factor, and whether age is a stronger prognostic factor than stage, histology, and LOH 1p/16q, needs to be further explored. This may provide some insight into whether older patients need to be treated more intensively, as is already advised for adult WT patients.

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Section: Generalsupporting

confidence: 80%

The Clinical Relevance of Age at Presentation in Nephroblastoma

et al. 2016

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“…In many of the east Asian series, Wilms' tumour occurred at a much earlier age than elsewhere, indeed the highest incidence was found in infancy. Incidence rates for Wilms' tumour were not available for children of East Asian ethnic groups in the United States, but the Asian children in the NWTS had a mean age of 29.1 months compared with 43.7 months for Whites (Breslow et al, 1988 Muir et al, 1987) though this was based on only four cases. During 1960-84, the incidence of renal tumours in Asian children in Hawaii was less than two thirds of that in Whites (Goodman et al, 1989).…”

Section: Resultsmentioning

confidence: 99%

International variations in the incidence of childhood renal tumours

Stiller

Dm²

1990

Br J Cancer

144

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Summary The International Agency for Research on Cancer has coordinated a worldwide study of childhood cancer incidence, with data from over 50 countries. We present here the results on renal tumours. Wilms' tumour was the most common malignant kidney tumour in all regions. It is sometimes considered to be an 'index cancer of childhood' but it is clear from the present study that there is at least a threefold difference in incidence between the age-standardised annual rates of over 10 per million in the Black populations in the United States and Nigeria and those of around three per million in several East Asian populations. In White Caucasian populations, Wilms' tumour had an annual incidence of 6-9 per million, accounting for 5-7% of all childhood cancer. It was almost everywhere equally common in boys and girls, but the sex ratio in East Asia was M/F = 1.4:1. Age distributions were similar among White Caucasian and Black populations, with the peak incidence in the second year of life. In East Asia, however, 25-40% of the total incidence occurred in infants aged under I year, compared with around 15% in many Western series. Other studies have shown that, in the United States, Wilms' tumour has a lower incidence among Asian children than among Whites or Blacks and tends to occur at a younger age. The variation in patterns of incidence of Wilms' tumour along ethnic rather than geographical lines suggests that genetic predisposition is important in its aetiology. Renal carcinoma in childhood is rare throughout the world, with little sign of international variation. It accounted for a higher proportion of childhood renal tumours in East Asia but this was attributable to the lower incidence of Wilms' tumour in that region.The International Agency for Research on Cancer (IARC) recently coordinated the first comprehensive worldwide study of childhood cancer incidence in which data were collected wherever possible from population based registries and diagnostic groups were defined according to histology (Parkin et al., 1988a). The study included data from some 50 countries and a summary of some of the principal findings has been given elsewhere (Parkin et al., 1988b).Wilms' tumour is by far the commonest form of malignant kidney tumour in childhood. At one time it was believed to have a relatively constant incidence throughout the world and was thus proposed as an 'index tumour' of childhood (Innis, 1972). It was clear from the IARC study, however, that there is a three-to four-fold variation in the incidence of Wilms' tumour between different regions and ethnic groups. In this paper we present a more detailed account of the results for Wilms' tumour and other childhood renal tumours. Materials and methodsA detailed description of the methods used in collecting and coding the data is given in the monograph on the IARC study (Parkin et al., 1988a). The series included in the monograph all contained at least 200 cases of childhood cancer. Wherever possible, series were used from populationbased registries which were bel...

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“…Today, most WT patients are treated with a combination of surgery and chemotherapy, while cases exhibiting poor prognostic factors are treated with radiotherapy. Reports from the National Wilms' Tumor Studies (NWTS) identified lymph node metastases and anaplastic histology as the most significant factors predicting long-term survival [45]. As a result of treatment protocol improvement, the 5-year overall survival for patients with WT is now over 90 % [46].…”

Section: Wilms' Tumor Treatmentmentioning

confidence: 99%

Targeted therapy aimed at cancer stem cells: Wilms’ tumor as an example

2013

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Wilms' tumor (WT), a common renal pediatric solid tumor, serves as a model for a malignancy formed by renal precursor cells that have failed to differentiate properly. Here we review recent evidence showing that the tumors' heterogeneous cell population contains a small fraction of cancer stem cells (CSC) identified by two markers: Neural Cell Adhesion Molecule 1 (NCAM1) expression and Aldehyde dehydrogenase 1 (ALDH1) enzymatic activity. In vivo studies show these CSCs to both self-renew and differentiate to give rise to all tumor components. Similar to other malignancies, the identification of a specific CSC fraction has allowed the examination of a novel targeted therapy, aimed at eradicating the CSC population. The loss of CSCs abolishes the tumor's ability to sustain and propagate, hence, causing tumor degradation with minimal damage to normal tissue.

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Prognostic factors in nonmetastatic, favorable histology wilms' tumor. Results of the third national wilms' tumor study

Cited by 133 publications

References 16 publications

The Clinical Relevance of Age at Presentation in Nephroblastoma

The Clinical Relevance of Age at Presentation in Nephroblastoma

International variations in the incidence of childhood renal tumours

Targeted therapy aimed at cancer stem cells: Wilms’ tumor as an example

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