The National Wilms’ Tumor Study: A Progress Report

D’Angio, Giulio J.; Beckwith, J. Bruce; Bishop, Harry C.; Breslow, Norman E.; Evans, Audrey E.; Goodwin, Willard E.; King, Lowell R.; Pickett, Lawrence K.; Sinks, Lucius F.; Sutow, Wataru W.; Wolff, James A.

doi:10.1007/978-1-4684-2070-8_7

Cited by 9 publications

(9 citation statements)

References 5 publications

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“…The procedures and methods used in the second NWTS generally followed those of the first study.:! The opening date for Group I patients was October 1, 1974, and for all other groups, January 1,1975. Between those dates and July 15, 1978, a total of 755 children having a pre-or postoperative diagnosis of Wilms' tumor were registered in one of the three categories "randomized," "followed," or "not-on-study."…”

Section: Methodsmentioning

confidence: 99%

“…Any one or more occur: (1) The tumor has undergone biopsy or rupture before or during surgery; (2) there are implants on peritoneal surfaces; (3) there are involved lymph nodes beyond the abdominal peri-aortic chains; (4) the tumor is not completely removable because of local infiltration into vital structures.…”

Section: Gt-orcp I-tumor Limited To Kidney and Completely Excisedmentioning

confidence: 99%

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The treatment of Wilms' Tumor: Results of the second national Wilms' Tumor study

D’Angio

Evans

Breslow

et al. 1981

Cancer

398

129

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One-hundred-eighty-eight children up to 16 years of age were randomized in the second National Wilms' Tumor Study (NWTS) with tumors that were confined to the kidney and that had been totally excised (Group I). Most fared well whether treated for six or for 15 months with both actinomycin D (AMD) and vincristine (VCR). No postoperative radiation therapy (RT) was given. The two-year relapse-free survival (RFS) and two-year survival rates were 88 and 95%, respectively. Two-hundred-sixty-eight randomized patients with more advanced local lesions (Groups II and III) and 57 with distant metastases (Group IV) had postoperative RT and were scheduled for 15 months treatment with either AMD and VCR (Reg. C) or AMD plus VCR plus Adriamycin (Reg. D). The 77% two-year RFS rate for Reg. D was significantly different from the 63% with Reg. C. As in the first NWTS, patients with tumors of unfavorable histology (UH) had a significantly worse prognosis than those with favorable histology (FH), as did those with positive nodes. Survival rates at two years were 54% for UH vs. 90% for FH, and 54% vs. 82% for those with and without lymph node involvement.

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Section: Methodsmentioning

confidence: 99%

Section: Gt-orcp I-tumor Limited To Kidney and Completely Excisedmentioning

confidence: 99%

The treatment of Wilms' Tumor: Results of the second national Wilms' Tumor study

D’Angio

Evans

Breslow

et al. 1981

Cancer

398

129

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“…10 Another component was the energetic pursuit of metastatic disease. 6 Institutions that did not participate in one of the cooperative groups also were eligible for membership in the NWTS Group, The patient's group is decided by the surgeon in the operating room, and is confirmed by the pathologist. 10 Thus, multi-modal therapy delivered by an experienced team led to success in 55 of 68 new patients (81%) seen at the Boston institution.…”

mentioning

confidence: 99%

“…Radiation therapists meanwhile were debating the need for routine post-operative RT in every child with Wilms' tumor.21 These and other clinical, pathologic, and epidemiologic questions led participating investigators in the major cooperative groups dealing with childhood cancer to combine their forces, and the National Wilms' Tumor Study (NWTS) was begun in 1969. 6 Institutions that did not participate in one of the cooperative groups also were eligible for membership in the NWTS Group, TABLE…”

mentioning

confidence: 99%

Wilm's Tumor: An Update

D’Angio

Beckwith

Breslow³

et al. 1980

Cancer

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Major advances have been made against Wilms' tumor as a result of treatment methods developed by single institutions that then have been confirmed and extended by national cooperating groups. Better survival rates have been achieved, and therapy has been refined so that treatment can be reduced in early stage disease without jeopardizing tumor control. This results in fewer short- and long-term complications, an especially important consideration in children. Their organs and tissues are vulnerable to anti-mitotic treatments such as chemo- and radiotherapy, that can produce disabling if not lethal dysfunctions. This progress has been the result of the cooperative efforts by multiple specialists, and provides evidence of the value of such integrated studies. They have changed the outlook from a 90% death rate in the early years of this century to the 90% survival rate now possible with modern management.

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“…Within the past two decades there have been No. 6 WILMS' TUMOR: SURVIVORSHIP AND EPIDEMIOLOGY Griffel 3141 remarkable advances in treatment so that a cure rate of well above 70 per cent is now expected at major centers. It is therefore meaningful to consider how the efficacy of treatment may be generally increased not only by the refinement of therapeutic protocols but also by deployment of skilled teams, by encouraging or requiring appropriate referral, and by improvement of diagnostic procedures.…”

mentioning

confidence: 99%