K Pritchard-Jones1, V Moroz2, G Vujanić3, M Powis4, J Walker5, B Messahel6, R Hobson7, G Levitt8, A Kelsey9, C Mitchell10. 1. Molecular Haematology and Cancer Biology Unit, Institute of Child Health, University College London, London. Electronic address: k.pritchard-jones@ucl.ac.uk. 2. Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham. 3. Department of Pathology, School of Medicine, Cardiff University, Cardiff. 4. Department of Paediatric Surgery, Leeds Teaching Hospitals NHS Trust, Leeds. 5. Department of Paediatric Surgery, Royal Hallamshire Hospital, Sheffield. 6. Section of Paediatric Oncology, Institute of Cancer Research, Sutton. 7. Department of Health Sciences, University of Leicester, Leicester. 8. Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Trust, London. 9. Department of Pathology, Royal Manchester Children's Hospital, Manchester. 10. Department of Paediatric Oncology, Oxford Radcliffe Hospitals NHS Trust, Oxford, UK.
Abstract
BACKGROUND: The randomised findings of the UKW3 trial were that preoperative chemotherapy was associated with a more advantageous stage distribution and reduction in therapy burden versus immediate nephrectomy without compromising outcome in localised Wilms' tumour (WT). We analysed outcome in all WT registered in UKW3. PATIENTS AND METHODS: Seven hundred and eighteen WT cases (7% anaplastic) were registered in UKW3. We assigned a treatment stage and conducted survival analysis. RESULTS: Five-year event-free survival (EFS) and overall survival (OS) were 77.2% [95% confidence interval (CI) 73.9-80.2] and 87.5% (95% CI 84.8-89.7) after median follow-up of 9.5 years and 10.0 years, respectively. Five-year OS in localised non-anaplastic cases was 92.9% (95% CI 90.2-94.9). Anaplasia was associated with adverse outcome compared with non-anaplastic cases: 5-year EFS of 42.0% (95% CI 28.3-55.1) versus 79.8% (95% CI 76.5-82.7) and 5-year OS of 60% (95% CI 45.1-72.0) versus 89.6% (95% CI 87.0-91.7), respectively. Outcomes were similar for non-anaplastic stage I or II but significantly poorer in stage III cases than stage I. Five-year OS after relapse was 54.1% (95% CI 44.5-62.8). Forty-seven percent of non-anaplastic WT received anthracycline; 27% were treated with radiotherapy first line. CONCLUSION: These outcomes provide a baseline for future comparisons of WT treatment approach, burden and patient outcome.
RCT Entities:
BACKGROUND: The randomised findings of the UKW3 trial were that preoperative chemotherapy was associated with a more advantageous stage distribution and reduction in therapy burden versus immediate nephrectomy without compromising outcome in localised Wilms' tumour (WT). We analysed outcome in all WT registered in UKW3. PATIENTS AND METHODS: Seven hundred and eighteen WT cases (7% anaplastic) were registered in UKW3. We assigned a treatment stage and conducted survival analysis. RESULTS: Five-year event-free survival (EFS) and overall survival (OS) were 77.2% [95% confidence interval (CI) 73.9-80.2] and 87.5% (95% CI 84.8-89.7) after median follow-up of 9.5 years and 10.0 years, respectively. Five-year OS in localised non-anaplastic cases was 92.9% (95% CI 90.2-94.9). Anaplasia was associated with adverse outcome compared with non-anaplastic cases: 5-year EFS of 42.0% (95% CI 28.3-55.1) versus 79.8% (95% CI 76.5-82.7) and 5-year OS of 60% (95% CI 45.1-72.0) versus 89.6% (95% CI 87.0-91.7), respectively. Outcomes were similar for non-anaplastic stage I or II but significantly poorer in stage III cases than stage I. Five-year OS after relapse was 54.1% (95% CI 44.5-62.8). Forty-seven percent of non-anaplastic WT received anthracycline; 27% were treated with radiotherapy first line. CONCLUSION: These outcomes provide a baseline for future comparisons of WT treatment approach, burden and patient outcome.
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Authors: S L Gooskens; R Furtwängler; F Spreafico; H van Tinteren; J de Kraker; G M Vujanic; I Leuschner; A Coulomb-L'Herminé; J Godzinski; G Schleiermacher; S Stoneham; C Bergeron; K Pritchard-Jones; N Graf; M M van den Heuvel-Eibrink Journal: Br J Cancer Date: 2014-06-17 Impact factor: 7.640