Relapse of Wilms' tumour and detection methods: a retrospective analysis of the 2001 Renal Tumour Study Group–International Society of Paediatric Oncology Wilms' tumour protocol database

Brok, Jesper; López-Yurda, Marta; Tinteren, Harm van; Treger, Taryn D.; Furtwängler, Rhoikos; Graf, Norbert; Bergeron, Christophe; Heuvel‐Eibrink, Marry M. van den; Pritchard‐Jones, Kathy; Olsen, Øystein E.; Camargo, Beatriz de; Verschuur, Arnauld; Spreafico, Filippo

doi:10.1016/s1470-2045(18)30293-6

Cited by 71 publications

(78 citation statements)

References 30 publications

(35 reference statements)

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“…5 Additionally, median follow-up in this series is three years, and continuous surveillance is needed to completely evaluate the risks of the procedure, although recurrences mainly occur in the first two years. 25 The inherent biases of a retrospective study are one of the limitations of this paper. In particular, there was a substantial amount of missing information, such as the total number of WT at each center during the study period and postoperative care.…”

Section: Discussionmentioning

confidence: 93%

Minimally invasive surgery for unilateral Wilms tumors: Multicenter retrospective analysis of 50 transperitoneal laparoscopic total nephrectomies

Bouty

Blanc

Leclair

et al. 2020

Pediatric Blood & Cancer

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Purpose To evaluate feasibility and outcomes of minimally invasive surgery (MIS) in Wilms tumor (WT). Methods International multicenter review of MIS total nephrectomies for WT between 2006 and 2018. Medical records of confirmed WT were retrospectively assessed for demographic, imaging, treatment, pathology, and oncological outcome data. Results Fifty patients, with a median age of 38 months (6‐181), were included in 10 centers. All patients received neoadjuvant chemotherapy, as per SIOP protocol. Median tumor volume post‐chemotherapy was 673 mL (18‐3331), 16 tumors crossed the lateral border of the spine, and three crossed the midline. Six patients with tumors that crossed the lateral border of the spine (tumor volumes 1560 mL [299‐2480]) were converted to an open approach. There was no intraoperative tumor rupture. Overall, MIS was completed in 19% of the 195 nephrectomies for WT presenting during the study period. Tumor was stage I in 29, II in 16, and III in 5, and histology was reported as low in three, intermediate in 42, and high risk in five. Three patients had positive tumor margins. After a median follow‐up of 34 months (2‐138), there were two local recurrences (both stage I, intermediate risk, 7 and 9 months after surgery) and one metastatic relapse (stage III, high risk, four months after surgery). The three‐year event‐free survival was 94%. Conclusion MIS is feasible in 20% of WT, with oncological outcomes comparable with open surgery, no intraoperative rupture, and a low rate of local relapse. Ongoing surveillance is, however, needed to evaluate this technique as it becomes widespread.

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Section: Discussionmentioning

confidence: 93%

Minimally invasive surgery for unilateral Wilms tumors: Multicenter retrospective analysis of 50 transperitoneal laparoscopic total nephrectomies

Bouty

Blanc

Leclair

et al. 2020

Pediatric Blood & Cancer

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“…[21][22][23] The current study is limited by its retrospective design. [21][22][23] The current study is limited by its retrospective design.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies assessing the value of routine imaging in other soft-tissue and bone sarcomas have shown contradictory results, and this illustrates the necessity for tumorspecific studies assessing the value of surveillance imaging because its value is dependent on tumor-specific factors (eg, tumor biology and chance of survival after relapse). [21][22][23] The current study is limited by its retrospective design. We tried to limit this bias by using a standardized case report form.…”

Section: Discussionmentioning

confidence: 99%

Is surveillance imaging in pediatric patients treated for localized rhabdomyosarcoma useful? The European experience

Vaarwerk

Mallebranche

Affinita

et al. 2019

Cancer

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BACKGROUND: After the completion of therapy, patients with localized rhabdomyosarcoma (RMS) are subjected to intensive radiological tumor surveillance. However, the clinical benefit of this surveillance is unclear. This study retrospectively analyzed the value of off-therapy surveillance by comparing the survival of patients in whom relapse was detected by routine imaging (the imaging group) and patients in whom relapse was first suspected by symptoms (the symptom group). METHODS: This study included patients with relapsed RMS after the completion of therapy for localized RMS who were treated in large pediatric oncology hospitals in France, the United Kingdom, Italy, and the Netherlands and who were enrolled in the International Society of Paediatric Oncology Malignant Mesenchymal Tumor 95 (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004) study, the Italian Paediatric Soft Tissue Sarcoma Committee Rhabdomyosarcoma 96 (1996-2004) study, or the European Paediatric Soft Tissue Sarcoma Study Group Rhabdomyosarcoma 2005 (2005-2013) study. The survival times after relapse were compared with a log-rank test between patients in the imaging group and patients in the symptom group. RESULTS: In total, 199 patients with relapsed RMS were included: 78 patients (39.2%) in the imaging group and 121 patients (60.8%) in the symptom group. The median follow-up time after relapse was 7.4 years (interquartile range, 3.9-11.5 years) for survivors (n = 86); the 3-year postrelapse survival rate was 50% (95% confidence interval [CI], 38%-61%) for the imaging group and 46% (95% CI, 37%-55%) for the symptom group (P = .7). CONCLUSIONS: Although systematic routine imaging is the standard of care after RMS therapy, the majority of relapses were detected as a result of clinical symptoms. This study found no survival advantage for patients whose relapse was detected before the emergence of clinical symptoms. These results show that the value of off-therapy surveillance is controversial, particularly because repeated imaging may also entail potential harm. Cancer 2020;126:823-831.

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“…It was about 17.8% in the series of Aoba et al [7]. In 80% of cases relapses occur within 2 years after the first diagnosis [8]. The mean time to relapse was 4.38 months in our series.…”

Section: Comments and Discussionmentioning

confidence: 39%

“…The prognosis is poor as the stage rises. For Brok J et al [8] stage III and V are considered as risk factors. The surgical stage was decisive in the occurrence of recurrences (p < 0.05).…”

Section: Tumor Surgical Stagementioning

confidence: 99%

Factors of Nephroblastomas’ Relapse in Children at the Academic Hospital Gabriel Toure, Bamako, Mali

Konaté¹,

Yacaria²,

Karim³

et al. 2020

OJPed

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Introduction: The factors of nephroblastomas' relapse are a set of elements playing a role in the reappearance of cancer cells in the same place of the kidney or in other regions of the body after a 5-year remission. Objectives: To determine the frequency and the factors of nephroblastomas' relapse in the pediatric oncology unit and pediatric surgery of the academic hospital Gabriel Touré. Materials and methods: This was a retrospective study carried out from January 1, 2005 to December 31, 2019 in all children treated for nephroblastoma relapses in the pediatric oncology unit and in the pediatric surgery service. Results: In 15 years, we have managed 182 cases of nephroblastoma, of which 128 cases were declared in complete remission after 5 years and 12 cases presented a recurrence. The relapses factors were: capsular break, intraoperative tumor rupture, presence of an associated malformation, surgery without neoadjuvant chemotherapy and tumor surgical stage (p < 0.05). Patients' age at diagnosis, sex, number of neoadjuvant and adjuvant chemotherapy sessions and histological type were not decisive (p > 0.05). Conclusion: Relapses are more and more frequent in cases of nephroblastoma. The correct use of the protocol would avoid these recurrences.

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Relapse of Wilms' tumour and detection methods: a retrospective analysis of the 2001 Renal Tumour Study Group–International Society of Paediatric Oncology Wilms' tumour protocol database

Cited by 71 publications

References 30 publications

Minimally invasive surgery for unilateral Wilms tumors: Multicenter retrospective analysis of 50 transperitoneal laparoscopic total nephrectomies

Minimally invasive surgery for unilateral Wilms tumors: Multicenter retrospective analysis of 50 transperitoneal laparoscopic total nephrectomies

Is surveillance imaging in pediatric patients treated for localized rhabdomyosarcoma useful? The European experience

Factors of Nephroblastomas’ Relapse in Children at the Academic Hospital Gabriel Toure, Bamako, Mali

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