The prognostic significance of blastemal predominant histology in initially resected Wilms’ tumors: A report from the Study Group for Pediatric Solid Tumors in the Kyushu Area, Japan

Kinoshita, Yoshiaki; Suminoe, Aiko; Inada, Hiroko; Yagi, Minoru; Yanai, Fumio; Zaizen, Yoshio; Nishi, Masanori; Inomata, Yukihiro; Kawakami, Kiyoshi; Matsufuji, Hiroshi; Suenobu, Souichi; Handa, Noritoshi; Kohashi, Kenichi; Oda, Yoshinao; Hara, Toshiro; Taguchi, Tomoaki

doi:10.1016/j.jpedsurg.2012.09.009

Cited by 25 publications

(21 citation statements)

References 15 publications

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“…In the present study, the incidence of pre‐chemotherapy blastemal predominant type WT (16.1% of all WT), was lower than that previously variously reported as 39.4% ( n = 28/71), 38.5% ( n = 5/13), 36.2% ( n = 9/28), 25% ( n = 95/378), and a little higher than that reported as 14.9% ( n = 26/174) . No ethnic difference in the incidence of pre‐chemotherapy blastemal predominant type WT was determined.…”

Section: Discussionsupporting

confidence: 89%

“…Few studies have described the relapse rate for pre‐chemotherapy blastemal predominant type WT. Previous reports from the Japanese local areas have variously indicated relapse and death rates of 55.6% (5/9 patients) and 11.1% (1/9 patients), 50% (13/26 patients) and 34.6% (9/26 patients), and 28.6% (6/21 patients) and 4.8% (1/21 patients), respectively. These Japanese reports have noted markedly high relapse rates in pre‐chemotherapy blastemal predominant type WT, but the cause of the poor prognosis was undetermined, and the pathology findings and diagnostic criteria were not described in detail.…”

Section: Discussionmentioning

confidence: 93%

“…No previous report has described gender differences in blastemal predominant type WT . Also, with regard to age distribution, pre‐chemotherapy blastemal predominant type WT was seen in older children (median age, 46.7 months old) compared with non‐blastemal type WT (31.2 months old; P < 0.001), which is in line with the previous reports . With regard to stage distribution, blastemal predominant type WT was diagnosed at a higher stage than non‐blastemal type WT ( P = 0.008), indicating the same tendency for stage distribution in patients with preoperative chemotherapy as in the previous SIOP study …”

Section: Discussionmentioning

confidence: 99%

“…Although upfront nephrectomy has been done for WT in many pediatric oncology centers, recent reports from local Japanese areas have described pre‐chemotherapy blastemal predominant type WT to be also a risk factor for relapse . The peculiar characteristics and significance of blastemal predominant histology, however, remain to be evaluated in a larger Japanese cohort.…”

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confidence: 99%

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Blastemal predominant type Wilms tumor in Japan: Japan Children's Cancer Group

Koshinaga

Takimoto

Okita

et al. 2019

Pediatrics International

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Background: Persistence of blastemal components after chemotherapy is a marker of poor outcome in Wilms tumor (WT). Recent reports from local Japanese areas have described pre-chemotherapy blastemal predominant type WT to also be a risk factor for relapse. The significance, however, of blastemal predominant WT remains to be evaluated in a larger study. This study retrospectively evaluated the prognostic significance of pre-chemotherapy blastemal predominant type WT in the Japan Wilms tumor Study (JWiTS) trials. Methods: The JWiTS trial (1996-2013) was a prospective, single-arm study. The outcomes of blastemal predominant type WT were retrospectively evaluated compared with non-blastemal type WT excluding anaplasia between 1996 and 2013. Relapse-free survival (RFS) and overall survival (OS) were estimated. Results: Of 319 primary renal tumors diagnosed by the central pathology review system, advanced stage of prechemotherapy blastemal predominant type WT (n = 53; 16.1%) occurred more frequently in older children than non-blastemal type WT (n = 225), and was especially frequent in female patients registered in the JWiTS trials. No significant difference in 10 years RFS and OS (78.8% vs 84.5; P = 0.201) or in 10 years RFS and OS (89.3% vs 93.5; P = 0.45) was seen between pre-chemotherapy blastemal predominant type and non-blastemal type WT. Conclusions: Relapse-free survival and OS are not significantly different between pre-chemotherapy blastemal predominant type and non-blastemal type WT.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Blastemal predominant type Wilms tumor in Japan: Japan Children's Cancer Group

Koshinaga

Takimoto

Okita

et al. 2019

Pediatrics International

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“…Therefore, the treatment strategy for the blastemal predominant category should be distinguished from that of the other favorable subtypes. 15 The last three studies were performed using Japanese WT patients. Therefore, the Japanese Wilms Study Group (JWiTS) plans to confirm that these factors are useful to predict outcome, and to identify the factors that are most critical in establishing a risk classification system in the next clinical trials for WT.…”

Section: Prognostic Factors For Nephroblastomamentioning

confidence: 99%

Management of pediatric renal tumor: Past and future trials of the Japan Wilms Tumor Study Group

Oue¹,

Fukuzawa²,

Koshinaga³

et al. 2015

Pediatrics International

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The Japan Wilms Tumor Study group (JWiTS) was founded in 1996 to improve outcomes for children with renal tumor in Japan, and a nationwide multicenter cooperative study was initiated thereafter. JWiTS-1 (1996JWiTS-1 ( -2005 was analyzed, and JWiTS-2 (2005JWiTS-2 ( -2014 is now under analysis; the following problems have been identified and used to decide future study protocol: (i) there has been a decline in survival rate for patients with rhabdoid tumor of the kidney (RTK) and new treatment strategies are required; (ii) the survival rate for bilateral Wilms tumors (BWT) has improved, but results for renal preservation are unsatisfactory; (iii) the prognosis of stage IV favorable nephroblastoma is very good, suggesting that the current protocols provide overtreatment, particularly for patients with lung metastasis; and (iv) no effective biological risk factors exist for predicting the outcome of Wilms tumor, and a study of the genetic changes of these tumors is necessary to determine biological markers for use in risk classification. To solve these issues, the development of a new risk classification of pediatric renal tumors is required. In addition, different study protocols should be developed according to the risk-based classification of the patients. Further, a new study protocol for BWT began in 2015, and new study protocols are being prepared for RTK, and for Wilms tumor with lung metastasis. In addition, an analysis of biological markers with regard to risk classification is to be performed. Furthermore, to create new protocols for patients with rare renal tumors, international collaboration with Children's Oncology Group and International Society of Pediatric Oncology is necessary.

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Higher incidence of surgery‐related complications in Wilms tumor nephrectomy from clinical records analysis compared with central database registration

Poll¹,

Wilde

Ven

et al. 2018

Pediatric Blood & Cancer

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Background/Objectives Central database registrations are widely used tools for assessment of clinical results, but their reliability is subject to debate. The aim of this study is to evaluate the reliability of central database registration for Wilms tumor (WT) nephrectomy‐related complications. Design/Methods All Dutch patients undergoing WT nephrectomy according to the International Society of Paediatric Oncology (SIOP) 2001 protocol between 2001 and 2013 were evaluated. Results from the central database were analyzed and compared with data found via individual medical records analysis (gold standard). Results A total of 179 patients were included. Fourteen (7.8%) patients with a total of 17 complications were identified in the central database. The medical records revealed that 33 (18.4%) of patients had undergone a total of 41 complications (P < 0.001). Operative complications were similar between the groups (P = 0.157). Eleven short‐term complications were noted in the central database versus 27 in the medical records (P = 0.059). Significantly more long‐term complications, namely, adhesive small‐bowel obstruction, were noted from the medical records compared with the central database (7 vs 1, respectively, P < 0.001). Postoperative chemotherapy was significantly delayed by on average 6 days (P < 0.0001) in patients with complications. No significant effect of complications on event‐free survival, overall survival, or the relapse rate was recorded. Conclusion Central database registrations underestimate the incidence of surgery‐related complications after WT nephrectomy and need to be regarded with caution.

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The prognostic significance of blastemal predominant histology in initially resected Wilms’ tumors: A report from the Study Group for Pediatric Solid Tumors in the Kyushu Area, Japan

Cited by 25 publications

References 15 publications

Blastemal predominant type Wilms tumor in Japan: Japan Children's Cancer Group

Blastemal predominant type Wilms tumor in Japan: Japan Children's Cancer Group

Management of pediatric renal tumor: Past and future trials of the Japan Wilms Tumor Study Group

Higher incidence of surgery‐related complications in Wilms tumor nephrectomy from clinical records analysis compared with central database registration

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