Comparison between single-dose and divided-dose administration of dactinomycin and doxorubicin for patients with Wilms' tumor: a report from the National Wilms' Tumor Study Group.

Abstract

We conclude that patients treated with PI combination chemotherapy for LR or HR WT or clear cell sarcoma of the kidney have equivalent 2-year RFS to those treated with STD regimens. PI drug administration is recommended as the new standard based on demonstrated efficacy, greater administered dose-intensity, less severe hematologic toxicity, and the requirement for fewer physician and hospital encounters.

Value and difficulties of a common European strategy for recurrent Wilms’ tumor

“…The outcome for children with Wilms tumor (WT) has improved significantly with the refinement of multimodal therapy and overall survival (OS) rates are now approaching 90% [1][2][3]. These results support the strong value of the multidisciplinary team approach to cancer.…”

A Surveillance, Epidemiology and End Results (SEER) program comparison of adult and pediatric Wilms' tumor

“…22 The listed year of diagnosis was used to categorize the patients into 1 of 4 treatment eras between 1973 and 2007 defined by the publication years of the NWTS 2, 3, and 4 trials. [24][25][26] Patient parameters were statistically compared between age groups to assess for variable heterogeneity. The continuous variables were statistically compared with the Student t test, and categorical variables were compared with Pearson's chi-square test except when the data set Original Article was relatively small, in which case the Fisher exact test was used.…”

“…The SIOP report included only 30 adult patients compared with 847 pediatric patients in the SIOP 93-01 trial publication, representing approximately 3%. 26,31 This difference in adult proportions between the SEER and trial group databases likely stems from the reluctance of adult oncologists, who may not have established institutional ties with either NWTS or SIOP, to register adult patients on a specific protocol. The current study is based on the SEER database, which includes a cohort of patients from geographically diverse rural and urban areas treated in academic and community practice settings and likely not treated on any specific trial.…”

“…41 In fact, in NWTS 4, it was found that 12 out of 1439 (0.8%) patients originally diagnosed with favorable histology Wilms' tumor by their institution actually had clear cell sarcoma of the kidney on central pathology review. 42 A significant portion of the pediatric patients in the SEER database likely have had central pathology review due to concurrent registration on NWTS protocols; however, it is probable that only a small portion of registered adult cases would have received such a thorough examination. A higher rate of pathological misdiagnosis might also result in undertreatment and worse outcome for adult patients.…”

Efficient estimation in multi-phase case-control studies

“…The studies from which the data originated were performed by the US National Wilms Tumor Study Group (DAngio et al, 1989;Green et al, 1998). Wilms tumor is a rare kidney cancer occurring in young children.…”