New definitions of focal and diffuse anaplasia in Wilms tumor: The International Society of Paediatric Oncology (SIOP) experience

Vujanić, Gordan; Harms, D.; Sandstedt, Bengt; Weirich, A.; Kraker, Jan de; Delemarre, J. F. M.

doi:10.1002/(sici)1096-911x(199905)32:5<317::aid-mpo1>3.0.co;2-f

Cited by 75 publications

(56 citation statements)

References 11 publications

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“…However, the histological assessment of tumors after chemotherapy makes subtyping and staging more challenging . In some WTs, it may be difficult to distinguish viable, hypocellular stroma from chemotherapy‐induced changes, and some postchemotherapy histological changes may mimic anaplasia . The histological features of viable tumor can be altered as chemotherapy is known to induce differentiation and maturation in WT, as well as in other pediatric tumors, such as neuroblastoma and rhabdomyosarcoma .…”

Section: Discussionmentioning

confidence: 93%

“…7,8 In some WTs, it may be difficult to distinguish viable, hypocellular stroma from chemotherapy-induced changes, and some postchemotherapy histological changes may mimic anaplasia. 19 The histological features of viable tumor can be altered as chemotherapy is known to induce differentiation and maturation in WT, 7,8 as well as in other pediatric tumors, such as neuroblastoma 6,20 and rhabdomyosarcoma. 6,21 Nevertheless, standard preoperative chemotherapy makes it possible to identify prognostically important WT types, such as completely necrotic and blastemal types, and it does not obscure or induce anaplasia.…”

Section: Discussionmentioning

confidence: 99%

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The effect of preoperative chemotherapy on histological subtyping and staging of Wilms tumors: The United Kingdom Children's Cancer Study Group (UKCCSG) Wilms tumor trial 3 (UKW3) experience

Vujanić

D’Hooghe

Popov

et al. 2018

Pediatric Blood & Cancer

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Background Two principal approaches to Wilms tumor (WT) treatment are immediate surgery (IS) and preoperative chemotherapy (PCT), and both treatments use the risk‐adapted approach that includes histological subclassification of the tumor, combined with additional prognostic factors. In the UKW3 trial, these two approaches were compared. The aim of the present study was to compare histological features between the two groups, to assess the impact of PCT on distribution of histological subtyping and staging and to evaluate whether PCT resulted in more staging discrepancies between local and central pathology review (CPR). Materials and methods The cases were identified from the UKW3 trial database. The criteria for inclusion in the study were unilateral, nonmetastatic, nonanaplastic WTs, and submitted for CPR with an adequate number of slides. They were subclassified according to the NWTS and later the SIOP 9301 criteria. Results There were 244 WTs in the IS and 182 in the PCT group subclassified as follows: blastemal 86 (35%) vs 9 (5%), epithelial 34 (14%) vs 12 (7%), stromal 12 (5%) vs 25 (14%), mixed 112 (46%) vs 45 (25%), respectively, plus 40% regressive and 10% completely necrotic WTs in the PCT group. The differences between the two groups for blastemal and mixed types were statistically significant. In the PCT group, there was a significant decrease in stage III tumors. The discrepancies in staging between local and CPR were not significant. Conclusion PCT significantly altered histological features and typing of WTs. It resulted in fewer stage III tumors, and staging discrepancies were equally represented in both groups.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

The effect of preoperative chemotherapy on histological subtyping and staging of Wilms tumors: The United Kingdom Children's Cancer Study Group (UKCCSG) Wilms tumor trial 3 (UKW3) experience

Vujanić

D’Hooghe

Popov

et al. 2018

Pediatric Blood & Cancer

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“…Therefore, there is a clinical need to further improve patient selection for either more or less intensive first-line therapy according to a more individualized prediction of their relapse risk. Currently, well-established prognostic factors for risk-adapted treatment stratification include tumor stage and histology; in particular, diffuse anaplasia in pretreated (Vujanic et al, 1999(Vujanic et al, , 2002 as well as in chemotherapy-na€ ıve tumors (Dome et al, 2006;Faria et al, 1996) and blastemal type in pretreated tumors (Vujanic et al, 2002). In addition, the molecular markers loss of heterozygosity (LOH) at 1p and 16q have been identified as markers of poor prognosis in chemotherapy-na€ ıve tumors and are now used for treatment stratification in COG studies (Grundy et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Gain of 1q is a marker of poor prognosis in Wilms' tumors

Segers

Heuvel‐Eibrink

Williams³

et al. 2013

Genes Chromosomes & Cancer

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Wilms' tumor (WT) trials aim to better tailor treatment intensity to the risk of relapse and death. Currently, stage, histology, age (< or > 24 months), and combined loss of heterozygosity at 1p and 16q in chemotherapy-naïve WTs are the only risk factors used for treatment stratification. However, they predict only less than one-third of all relapsing patients, implying that other factors are involved in treatment failure. Previous studies have associated 1q gain with adverse outcome. Therefore, in this study, the role of 1q gain and other common cytogenetic aberrations (CAs) in WTs was investigated and related to follow-up data from patients with WT treated in the United Kingdom; 19% (64/331) had 1q gain. Gain of 1q was significantly associated with 16q loss (P < 0.001) and 1p loss (P < 0.001). In multivariate analysis taking account of age, tumor stage, anaplasia, and common CA (e.g., 1p loss and 16q loss), 1q gain was independently associated with adverse event-free survival [EFS; hazard ratio (HR) = 2.45, P = 0.02] and overall survival (HR = 4.28, P = 0.004). Loss of 14q was independently associated with an adverse EFS (HR = 4.0, P = 0.04). Gain of 1q is a marker of poor prognosis in WTs, independent of high tumor stage and anaplasia which remain the overarching adverse prognostic factors. Confirmation in other studies is necessary before future therapeutic studies can incorporate 1q gain into new risk stratification schema.

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“…C'est un élément très péjoratif témoignant d'une chimiorésistance de la tumeur et nécessitant des protocoles de chimiothérapie très agressifs. Lorsque l'anaplasie reste focale, la tumeur est classée dans le groupe des tumeurs de risque intermédiaire [5].…”

Section: Microscopieunclassified

Tumeurs du rein de l’enfant et de l’adolescent

L’Herminé-Coulomb

2014

Pathologie Tumorale Rénale

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New definitions of focal and diffuse anaplasia in Wilms tumor: The International Society of Paediatric Oncology (SIOP) experience

Cited by 75 publications

References 11 publications

The effect of preoperative chemotherapy on histological subtyping and staging of Wilms tumors: The United Kingdom Children's Cancer Study Group (UKCCSG) Wilms tumor trial 3 (UKW3) experience

The effect of preoperative chemotherapy on histological subtyping and staging of Wilms tumors: The United Kingdom Children's Cancer Study Group (UKCCSG) Wilms tumor trial 3 (UKW3) experience

Gain of 1q is a marker of poor prognosis in Wilms' tumors

Tumeurs du rein de l’enfant et de l’adolescent

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