The Relationship Between the Site of Metastases and Outcome in Children With Stage IV Wilms Tumor: Data From 3 European Pediatric Cancer Institutions

Berger, Michael; Fernandez-Pineda, Israel; Cabello, Rosa; Ramirez-Villar, Gema Lucia; Marquez-Vega, Catalina; Nustede, Rainer; Linderkamp, Christin; Schmid, Irene; Neth, Olaf; Graf, Norbert; Agustin, Juan Carlos de; Schweinitz, Dietrich von; Lacher, Martin and Hubertus, Jochen (October 2013): The Relationship Between the Site of Metastases and Outcome in Children With Stage IV Wilms Tumor: Data From 3 European Pediatric Cancer Institutions. In: Journal of Pediatric Hematology/Oncology, Vol. 35, No. 7: pp. 518-524

Abstract

The aim of this study was to analyze in detail the site of metastasis of stage 4 Wilms tumor (WT) and its correlation with outcome. The databases from 3 major European pediatric cancer institutions were screened for children with WT between 1994 and 2011. Of 208 children identified, 31 (14.9%) had metastases at diagnosis. The lung was affected in 29 children (93.5%) and the liver in 6 children (19.4%). Twenty-seven children (87.1%) had metastases isolated to 1 organ, with the lung being the most common site (80.7%). Five-year overall survival was significantly better in those children with distant disease in either lung or liver (95.8%) compared with those affected in both lung and liver (57.1%, P=0.028). Further, prognostic markers were the response of metastases to preoperative chemotherapy (P=0.0138), high-risk histology (P=0.024), and local stage (P=0.026). Five-year overall survival was 82.1% and 5-year event-free survival was 67.9%. The overall follow-up time was 74.1 and 87.2 (2 to 151) months among survivors, and the treatment-related complication rate was 16.7%. In conclusion, in our series of stage 4 WT, prognosis was excellent if histology was favorable, metastatic disease was isolated to either lungs or liver, and if metastases responded to preoperative chemotherapy.

• Item Type: Journal article
• Form of publication: Publisher's Version
• Keywords: metastases; pediatric cancer; risk stratification; survival; Wilms tumor
• Faculties: Medicine
• Subjects: 600 Technology > 610 Medicine and health
• ISSN: 1077-4114
• Place of Publication: 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
• Alliance/National Licence: This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.
• Language: English