Outcome of pediatric renal tumor treated using the Japan Wilms Tumor Study-1 (JWiTS-1) protocol: a report from the JWiTS Group

Oue, Takaharu; Fukuzawa, Masahiro; Okita, Hajime; Mugishima, Hideo; Hara, Hiroshi; Hata, Junichi; Saito, Masahiro; Nozaki, Miwako; Chin, Motoaki; Nakadate, Hisaya; Hinotsu, Shiro; Koshinaga, Tsugumichi; Kaneko, Yasuhiko; Kitano, Yoshihiro; Tanaka, Yukichi

doi:10.1007/s00383-009-2449-0

Cited by 44 publications

(55 citation statements)

References 22 publications

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“…In nephroblastoma patients, the 5 year OS was 90.5% for stage I disease, 92.2% for stage II, 90.9% for stage III, 86.7% for stage IV, and 78.7% for stage V. 5 OS for patients in the JWiTS-1 study was similar to that in other multicenter studies in the USA and Europe. With regard to the results of the past JWiTS studies, the following problems were identified.…”

supporting

confidence: 70%

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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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confidence: 70%

“…5 The protocol regimens used were similar to those of the NWTS-5 regimens. A total number of 307 patients with malignant renal tumors were enrolled in the JWiTS-1 study between 1996 and 2005, but centralized pathological diagnosis and follow-up data were available only in 210 cases.…”

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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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“…1,11,12 About 10% to 15% of these patients were associated with recognized malformations such as WAGR syndrome, Denys-Drash syndrome, hypospadias, and other genitourinary tract anomalies. 17 The lower overall 5-year patient survival (69.7%) in this study may be because of advance stage, as more than half of the patients had stage 3 or more. 14 Another study in nearly 6000 patients with Wilms tumor revealed cumulative risks of renal failure at 20 years from diagnosis in Denys-Drash and Wilms tumor-Aniridia syndromes of 62% and 38%, respectively.…”

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confidence: 60%

“…The tumor often occurred in children younger than 5 years, without male or female preponderance. 5,17 A study of 210 pediatric renal tumor cases from Japan revealed 5-year survivals of 91.1%, 74.5%, and 22.2% for patients with Wilms tumor, clear cell sarcoma of the kidney, and rhabdoid tumor of the kidney, respectively. 13 Patients with WAGR were reported to have a 50% chance of end-stage renal disease, 20 years after treatment.…”

Section: Discussionmentioning

confidence: 99%

Long-term Outcome in Pediatric Renal Tumor Survivors

Sanpakit

Triwatanawong²,

Sumboonnanonda³

2013

Journal of Pediatric Hematology/Oncology

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Medical records of 30 children with renal tumor diagnosed at Siriraj Hospital during 1996 to 2007 were reviewed. Mean age at diagnosis was 36 months; male to female ratio was 1.7:1. Clinical manifestations included abdominal mass (96.7%), hypertension (40.0%), abdominal pain (36.7%), hematuria (26.7%), postrenal obstruction (16.7%), and proteinuria (13.3%). Eight patients had Denys-Drash malformations, WAGR, Dandy-Walker malformation, or genitourinary anomalies. Twenty-seven patients (90%) had Wilms tumor. Sixteen patients were stage 3 or more at diagnosis. Rhabdoid tumor was found in 3 patients. All patients received chemotherapy, 13 patients also received radiation therapy. Acute complications included febrile neutropenia (44.4%), hypokalemia (37.0%), hyponatremia (29.6%), Fanconi syndrome (11.1%), urinary tract Infection (10.0%), and acute renal failure (7.4%). Mean follow-up time was 57.2 months. Ten patients died from progressive disease. Five-year patient survival was 69.7%. Two patients had chronic kidney disease. One of these had Denys-Drash malformations. Both patients received ifosfamide-carboplatin-etoposide protocol and abdominal radiation. Antihypertensive medications were needed in 9 patients for a mean duration of 164 days. None had persistent proteinuria or hematuria. No difference was found among mean estimated glomerular filtration rate at diagnosis, 1 year after treatment, and at last follow-up. Long-term follow-up, especially renal function, is recommended.

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“…In malignant renal tumors, all patients underwent an initial nephrectomy according to the protocol proposed by the Japan Wilms Tumor Study Group (JWiTS) [10]. The therapeutic strategy was similar to that of the National Wilms Tumor Study (NWTS)-5 protocols.…”

Section: Introductionmentioning

confidence: 99%

The clinical course in pediatric solid tumor patients with focal nodular hyperplasia of the liver

et al. 2011

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Outcome of pediatric renal tumor treated using the Japan Wilms Tumor Study-1 (JWiTS-1) protocol: a report from the JWiTS Group

Cited by 44 publications

References 22 publications

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

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

Long-term Outcome in Pediatric Renal Tumor Survivors

The clinical course in pediatric solid tumor patients with focal nodular hyperplasia of the liver

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