Clinical outcomes of children with Wilms tumor treated on a SIOP WT 2001 protocol in a tertiary care hospital in south India

John, Rebecca; Kurian, Jujju Jacob; Sen, Sudipta; Gupta, Manish Kumar; Jehangir, Susan; Mathew, Leni Grace; Mathai, John

doi:10.1016/j.jpurol.2018.05.020

Cited by 25 publications

(35 citation statements)

References 20 publications

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“…Metastatic WT has a worse prognosis than localized disease and is less frequently seen in developed countries compared to developing world [6]. This study included 24 metastatic WT patients, constituting 23.3% of all WT patients presented to NCI, Egypt, during the study period.…”

Section: Discussionmentioning

confidence: 99%

Management and outcome of pediatric metastatic Wilms’ tumor at the National Cancer Institute, Egypt

El‐Ayadi

Magdy

Khalil

et al. 2020

J Egypt Natl Canc Inst

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Background: Wilms' tumor (WT) is the most common renal malignant tumor of childhood. Metastatic WT has a worse prognosis than localized disease. This study aims to assess the clinical outcome and different prognostic factors that influence treatment outcome of pediatric metastatic WT cases treated at National Cancer Institute (NCI), Egypt, between January 2008 and December 2015. Medical records were retrospectively reviewed for clinical, radiological and histopathological data, treatment received, and survival outcome.Results: In the specified study period, 24/103 (23.3%) patients with WT were metastatic at presentation. The mean age was 5.25 ± 2.87 years (range 2.0-12.7). Abdominal swelling/mass was the commonest presentation (70.8%). Only 3 patients (12.5%) had combined lung and liver metastases while 21 patients (87.5%) had pulmonary-only metastases. All patients had favorable histology tumors with no anaplasia. Nine patients (37.5%) underwent upfront nephrectomy. Majority of patients (91.7%) had local stage III disease. Surgical complications were reported in 4 patients; 3 of them had up-front nephrectomy. Only 7/21 patients achieved rapid complete response of pulmonary nodules after 6 weeks of chemotherapy (CTH), and they had a better survival outcome. Patients were followed up till December 2017. Thirteen patients (54.1%) experienced events during the study period including 5 relapses, 6 cases with disease progression, and 2 patients died out of sepsis. The 3-year event-free and overall survival rates were 48.2% and 54.2%, respectively. Conclusion: Neo-adjuvant CTH followed by delayed nephrectomy seems more suitable approach in our institute. Pulmonary response to neo-adjuvant CTH appears to be a strong predictor for outcome.

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Section: Discussionmentioning

confidence: 99%

Management and outcome of pediatric metastatic Wilms’ tumor at the National Cancer Institute, Egypt

El‐Ayadi

Magdy

Khalil

et al. 2020

J Egypt Natl Canc Inst

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“…Of the 95 children included in the current study, 34 (36%) were described in the previous report from the center. 8 The median age of the patients was 40 months (range 8-135). The male to female ratio was 1.…”

Section: Resultsmentioning

confidence: 99%

“…7 We have previously published the experience of managing children with WT treated between 2004 and 2014 at the center. 8 The present study ascertained the prognostic value of the postchemotherapy tumor volume in a large cohort of children with WT treated over the last 15 years.…”

Section: Introductionmentioning

confidence: 99%

Postchemotherapy tumor volume as a prognostic indicator in Wilms tumor: A single‐center experience from South India

Joseph¹,

Boddu²,

Srinivasan³

et al. 2021

Pediatric Blood & Cancer

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Background: Optimal risk stratification is the key to minimizing relapse and toxicity in children with Wilms tumor (WT). The study evaluated poor tumor volume response to chemotherapy as a risk factor that predicts relapse. Procedure: Children with WT who were treated between 2005 and 2020 at the center were analyzed. Tumor volumes at the time of diagnosis and after preoperative chemotherapy were calculated from cross-sectional imaging. The International Society of Paediatric Oncology (SIOP)-WT-2001 protocol was used for treatment. The area under a receiver operating characteristic curve was estimated to ascertain the ability of tumor volume to predict relapse.Results: Ninety-five patients with a median age of 40 months were included. A postchemotherapy tumor volume cutoff of 270 ml was ascertained to have the best predictive value for relapse. Patients with a tumor volume of <270 ml following preoperative chemotherapy had a better 3-year event-free survival (EFS) than those with a tumor volume of ≥270 ml (89.8% ± 4.0% vs. 57.4% ± 12.5%, p = .001). The data demonstrated that a tumor volume of ≥270 ml after chemotherapy was associated with an increased risk of relapse (hazard ratio [HR]: 5.3, p = .006). The EFS in patients with an epithelial or stromal type of histopathology was not affected by the tumor volume response (p = .437). Conversely, patients with other types of intermediate-risk histopathology who had a poor tumor volume response had an inferior survival (3-year EFS 51.4% ± 18.7%, p = .001). Conclusion:A postchemotherapy tumor volume cutoff of ≥270 ml emerged as a strong predictor of relapse in a low-and middle-income country (LMIC) center study of WT treated with the SIOP protocol.

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“…Retrospective analysis from a single centre in South India showed the EFS and OS to be 73% was 80% and the data from SEER up to 2014 showed OS to be 90.4%. 9,18 The three-year EFS and OS of NHL was 58.3% and 66.7%. These results were poorer compared to a retrospective study done in All India Institute of Medical Sciences, New Delhi, which reported the three-year EFS to be 82.6% until 2014.…”

Section: Discussionmentioning

confidence: 97%

Small steps towards bigger goals: A study of demography and outcome of paediatric cancers in a peripheral resource limited paediatric oncology centre

Bafna

Bartakke

Sampagar

et al. 2021

Int J Contemp Pediatr

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Background: The aim of this study was to analyze the demography, clinical profile and outcome of pediatric cancer cases from a peripheral resource limited center.Methods: We retrospectively analysed demography, clinical details and outcomes of 227 cases of paediatric cancer up to nineteen years of age, from August 2009 to May 2019. Their status of treatment was categorised as completed, ongoing, abandoned and expired. We generated Kaplan-Meier curves (KM) and calculated three-year event free survival (EFS) and overall survival (OS).Results: Out of 227 children, 139 (61.2%) were boys and the rest were girls. Maximum number of children 108 (47.6%) were aged zero to four years. The socioeconomic status of 70 patients using the Kuppuswammy scale showed that 55 patients (78.57%) belonged to a lower socio-economic stratum. The commonest malignancy was leukaemia 119(52.4%) followed by solid tumours constituting 84 (37%) patients, of which 25 (11.01%) were renal tumours. Out of total 227 patients, 107 (47.13%) have completed treatment, 45 (19.8%) were on treatment, 24 (10.6%) have abandoned and 51 (22.5%) had expired. The median duration of follow up was 18 months. The three-year EFS and OS were 71.9% and 74.8% respectively for the entire COHORT, 74.4% and 75.5% for ALL (Acute Lymphocytic Leukemia), 38.4% and 46.1% for AML (Acute Myeloid Leukemia) and 74.3% and 76.6% for solid tumours. Among solid tumours, three-year EFS and OS was of renal tumours 86.9% and of neuroblastoma was 77.7%.Conclusions: We achieved outcomes similar to those from well-established Indian single institute studies. The survival of our paediatric cancer patients can be improved with collaborative effort and establishment of new centres in the periphery.

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Clinical outcomes of children with Wilms tumor treated on a SIOP WT 2001 protocol in a tertiary care hospital in south India

Cited by 25 publications

References 20 publications

Management and outcome of pediatric metastatic Wilms’ tumor at the National Cancer Institute, Egypt

Management and outcome of pediatric metastatic Wilms’ tumor at the National Cancer Institute, Egypt

Postchemotherapy tumor volume as a prognostic indicator in Wilms tumor: A single‐center experience from South India

Small steps towards bigger goals: A study of demography and outcome of paediatric cancers in a peripheral resource limited paediatric oncology centre

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