Details

Autor(en) / Beteiligte

• DOME, Jeffrey S
• COTTON, Cecilia A
• HAASE, Gerald M
• COPPES, Max J
• COCCIA, Peter
• KLETZEL, Morris
• WEETMAN, Robert M
• DONALDSON, Milton
• MACKLIS, Roger M
• GREEN, Daniel M
• PERLMAN, Elizabeth J
• BRESLOW, Norman E
• KALAPURAKAL, John A
• RITCHEY, Michael L
• GRUNDY, Paul E
• MALOGOLOWKIN, Marcio
• BECKWITH, J. Bruce
• SHAMBERGER, Robert C

Titel

Treatment of Anaplastic Histology Wilms' Tumor: Results From the Fifth National Wilms' Tumor Study

Ist Teil von

• Journal of clinical oncology, 2006-05, Vol.24 (15), p.2352-2358

Ort / Verlag

Baltimore, MD: American Society of Clinical Oncology

Erscheinungsjahr

2006

Quelle

MEDLINE

Beschreibungen/Notizen

• An objective of the fifth National Wilms' Tumor Study (NWTS-5) was to evaluate the efficacy of treatment regimens for anaplastic histology Wilms' tumor (AH). Prospective single-arm studies were conducted. Patients with stage I AH were treated with vincristine and dactinomycin for 18 weeks. Patients with stages II to IV diffuse AH were treated with vincristine, doxorubicin, cyclophosphamide, and etoposide for 24 weeks plus flank/abdominal radiation. A total of 2,596 patients with Wilms' tumor were enrolled onto NWTS-5, of whom 281 (10.8%) had AH. Four-year event-free survival (EFS) and overall survival (OS) estimates for assessable patients with stage I AH (n = 29) were 69.5% (95% CI, 46.9 to 84.0) and 82.6% (95% CI, 63.1 to 92.4). In comparison, 4-year EFS and OS estimates for patients with stage I favorable histology (FH; n = 473) were 92.4% (95% CI, 89.5 to 94.5) and 98.3% (95% CI, 96.4 to 99.2). Four-year EFS estimates for patients who underwent immediate nephrectomy with stages II (n = 23), III (n = 43), and IV (n = 15) diffuse AH were 82.6% (95% CI, 60.1 to 93.1), 64.7% (95% CI, 48.3 to 77.7), and 33.3% (95% CI, 12.2 to 56.4), respectively. OS was similar to EFS for these groups. There were no local recurrences among patients with stage II AH. Four-year EFS and OS estimates for patients with bilateral AH (n = 29) were 43.8% (95% CI, 24.2 to 61.8) and 55.2% (95% CI, 34.8 to 71.7), respectively. The prognosis for patients with stage I AH is worse than that for patients with stage I FH. Novel treatment strategies are needed to improve outcomes for patients with AH, especially those with stage III to V disease.