BACKGROUND: Most relapses from Wilms' tumor occur within 2 years from diagnosis. This study aims to describe the incidence and outcome of patients who experienced a late recurrence (LR) more than 5 years after diagnosis across several clinical trials, and to develop evidence-based recommendations for follow-up surveillance. METHODS: Available records on children with Wilms' tumor enrolled onto 10 national or international cooperative clinical trials were reviewed to identify patients who experienced a LR. RESULTS: Seventy of 13,330 (0.5%) patients with Wilms' tumor experienced a LR. No gender bias was observed. Median time elapsing between initial Wilms' tumor diagnosis and first recurrence was 13.2 years (range: 5.1-17.3 years). Initial tumor stage was: stage I (15); stage II (19); stage III (14); stage IV (8); bilateral disease stage V (14). The most frequent sites of relapse were--abdomen: 21, lungs: 20, and contralateral kidney: 15. Thirty-five children died of disease progression. Recurrence in the contralateral kidney was associated with a better outcome (13/15 patients alive), while initial tumor stage did not seem to influence the post-recurrence outcome. Therapies administered at recurrence varied between centers, preventing any conclusion about the best salvage treatment. CONCLUSIONS: LR of Wilms' tumor is rare and associated with similar outcome to those experiencing earlier recurrence. The low rate of LR does not justify prolonged monitoring. Further study of the biology of these tumors may give us some insights in regards to mechanisms on tumor cell dormancy or cancer stem cell maintenance.
BACKGROUND: Most relapses from Wilms' tumor occur within 2 years from diagnosis. This study aims to describe the incidence and outcome of patients who experienced a late recurrence (LR) more than 5 years after diagnosis across several clinical trials, and to develop evidence-based recommendations for follow-up surveillance. METHODS: Available records on children with Wilms' tumor enrolled onto 10 national or international cooperative clinical trials were reviewed to identify patients who experienced a LR. RESULTS: Seventy of 13,330 (0.5%) patients with Wilms' tumor experienced a LR. No gender bias was observed. Median time elapsing between initial Wilms' tumor diagnosis and first recurrence was 13.2 years (range: 5.1-17.3 years). Initial tumor stage was: stage I (15); stage II (19); stage III (14); stage IV (8); bilateral disease stage V (14). The most frequent sites of relapse were--abdomen: 21, lungs: 20, and contralateral kidney: 15. Thirty-five children died of disease progression. Recurrence in the contralateral kidney was associated with a better outcome (13/15 patients alive), while initial tumor stage did not seem to influence the post-recurrence outcome. Therapies administered at recurrence varied between centers, preventing any conclusion about the best salvage treatment. CONCLUSIONS: LR of Wilms' tumor is rare and associated with similar outcome to those experiencing earlier recurrence. The low rate of LR does not justify prolonged monitoring. Further study of the biology of these tumors may give us some insights in regards to mechanisms on tumor cell dormancy or cancer stem cell maintenance.
Authors: Conrad V Fernandez; Elizabeth A Mullen; Yueh-Yun Chi; Peter F Ehrlich; Elizabeth J Perlman; John A Kalapurakal; Geetika Khanna; Arnold C Paulino; Thomas E Hamilton; Kenneth W Gow; Zelig Tochner; Fredric A Hoffer; Janice S Withycombe; Robert C Shamberger; Yeonil Kim; James I Geller; James R Anderson; Paul E Grundy; Jeffrey S Dome Journal: J Clin Oncol Date: 2017-12-06 Impact factor: 44.544
Authors: Jaime M Libes; Erin H Seeley; Ming Li; Jason R Axt; Janene Pierce; Hernan Correa; Mark Newton; Erik Hansen; Audra Judd; Hayes McDonald; Richard M Caprioli; Arlene Naranjo; Vicki Huff; James A O'Neill; Harold N Lovvorn Journal: J Am Coll Surg Date: 2014-01-24 Impact factor: 6.113
Authors: A M Ford; M B Mansur; C L Furness; F W van Delft; J Okamura; T Suzuki; H Kobayashi; Y Kaneko; M Greaves Journal: Leukemia Date: 2015-05-28 Impact factor: 11.528
Authors: Sophie E van Peer; Janna A Hol; Alida F W van der Steeg; Martine van Grotel; Godelieve A M Tytgat; Annelies M C Mavinkurve-Groothuis; Geert O R Janssens; Annemieke S Littooij; Ronald R de Krijger; Marjolijn C J Jongmans; Marc R Lilien; Jarno Drost; Roland P Kuiper; Harm van Tinteren; Marc H W A Wijnen; Marry M van den Heuvel-Eibrink Journal: J Clin Med Date: 2021-11-26 Impact factor: 4.241
Authors: Elizabeth J Perlman; Samantha Gadd; Stefan T Arold; Anand Radhakrishnan; Daniela S Gerhard; Lawrence Jennings; Vicki Huff; Jaime M Guidry Auvil; Tanja M Davidsen; Jeffrey S Dome; Daoud Meerzaman; Chih Hao Hsu; Cu Nguyen; James Anderson; Yussanne Ma; Andrew J Mungall; Richard A Moore; Marco A Marra; Charles G Mullighan; Jing Ma; David A Wheeler; Oliver A Hampton; Julie M Gastier-Foster; Nicole Ross; Malcolm A Smith Journal: Nat Commun Date: 2015-12-04 Impact factor: 14.919