Abstract
Three hundred and eighty one children with Wilms' tumour were treated on the United Kingdom Children's Cancer Study Group WT1 Study (1980/6). Seventy one patients relapsed during or after treatment, which included surgery and chemotherapy, with irradiation depending on stage and histology. Despite treatment with various combinations of chemotherapy, surgery, and radiotherapy there were only 17 survivors. For unfavourable histology, any stage, only two of 20 survive. We conclude that, after relapse, even for patients who have had localised disease and favourable histology, the 'salvage' rate is little more than 50% and for all others the likelihood of cure is very small. Three of 41 children who relapsed less than 12 months from diagnosis survive, compared with 14 of 30 who relapsed later. It is essential that even with this 'good prognosis' tumour initial treatment is optimal and given by centres experienced in management of children's cancer. Furthermore, there is a clear need for additional effective chemotherapeutic agents for relapsed patients.
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Selected References
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- Beckwith J. B., Palmer N. F. Histopathology and prognosis of Wilms tumors: results from the First National Wilms' Tumor Study. Cancer. 1978 May;41(5):1937–1948. doi: 10.1002/1097-0142(197805)41:5<1937::aid-cncr2820410538>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
- Burgers J. M., Tournade M. F., Bey P., Bürger D., Carli M., Delemarre J. F., Harms D., Jereb B., de Kraker J., Lemerle J. Abdominal recurrences in Wilms' tumours: a report from the SIOP Wilms' tumour trials and studies. Radiother Oncol. 1986 Mar;5(3):175–182. doi: 10.1016/s0167-8140(86)80047-0. [DOI] [PubMed] [Google Scholar]
- Clausen N. Late recurrence of Wilms tumor. Med Pediatr Oncol. 1982;10(6):557–561. doi: 10.1002/mpo.2950100605. [DOI] [PubMed] [Google Scholar]
- D'Angio G. J., Evans A., Breslow N., Beckwith B., Bishop H., Farewell V., Goodwin W., Leape L., Palmer N., Sinks L. The treatment of Wilms' tumor: results of the Second National Wilms' Tumor Study. Cancer. 1981 May 1;47(9):2302–2311. doi: 10.1002/1097-0142(19810501)47:9<2302::aid-cncr2820470933>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
- Grundy P., Breslow N., Green D. M., Sharples K., Evans A., D'Angio G. J. Prognostic factors for children with recurrent Wilms' tumor: results from the Second and Third National Wilms' Tumor Study. J Clin Oncol. 1989 May;7(5):638–647. doi: 10.1200/JCO.1989.7.5.638. [DOI] [PubMed] [Google Scholar]
- Jereb B., Eklund G. Factors influencing the cure rate in nephroblastoma. A review of 335 cases. Acta Radiol Ther Phys Biol. 1973 Apr;12(2):84–106. doi: 10.3109/02841867309130385. [DOI] [PubMed] [Google Scholar]
- Jereb B. Metastases and recurrences in nephroblastoma. Acta Radiol Ther Phys Biol. 1973 Aug;12(4):289–304. doi: 10.3109/02841867309131094. [DOI] [PubMed] [Google Scholar]
- Kaye S. B. The multidrug resistance phenotype. Br J Cancer. 1988 Dec;58(6):691–694. doi: 10.1038/bjc.1988.291. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kisielius T., Bianco A., Merrill J. M., Taylor S. G., 4th, DeWys W. Bleomycin in combination chemotherapy of metastatic Wilms tumor: a late recurrent case, refractory to conventional therapy. Med Pediatr Oncol. 1979;6(1):11–14. doi: 10.1002/mpo.2950060103. [DOI] [PubMed] [Google Scholar]
- Lemerle J., Voute P. A., Tournade M. F., Rodary C., Delemarre J. F., Sarrazin D., Burgers J. M., Sandstedt B., Mildenberger H., Carli M. Effectiveness of preoperative chemotherapy in Wilms' tumor: results of an International Society of Paediatric Oncology (SIOP) clinical trial. J Clin Oncol. 1983 Oct;1(10):604–609. doi: 10.1200/JCO.1983.1.10.604. [DOI] [PubMed] [Google Scholar]
- Mohammad A. M., Meyer J., Hakami N. Long-term survival following brain metastasis of Wilm's tumor. J Pediatr. 1977 Apr;90(4):660–660. doi: 10.1016/s0022-3476(77)80398-3. [DOI] [PubMed] [Google Scholar]
- Moncrieff M., Foot A. Fanconi syndrome after ifosfamide. Cancer Chemother Pharmacol. 1989;23(2):121–122. doi: 10.1007/BF00273531. [DOI] [PubMed] [Google Scholar]
- Morgan S. K., Buse M. G. Survival following brain metastases in wilms' tumor. Pediatrics. 1976 Jul;58(1):130–132. [PubMed] [Google Scholar]
- Pinkerton C. R., Rogers H., James C., Bowman A., Barbor P. R., Eden O. B., Pritchard J. A phase II study of ifosfamide in children with recurrent solid tumours. Cancer Chemother Pharmacol. 1985;15(3):258–262. doi: 10.1007/BF00263897. [DOI] [PubMed] [Google Scholar]
- Pritchard J., Stiller C. A., Lennox E. L. Overtreatment of children with Wilms' tumour outside paediatric oncology centres. BMJ. 1989 Sep 30;299(6703):835–836. doi: 10.1136/bmj.299.6703.835. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith W. B., Wara W. M., Margolis L. W., Kushner J. H., De Lorimier A. A. Partial hepatectomy in metastatic Wilms' tumor. J Pediatr. 1974 Feb;84(2):259–261. doi: 10.1016/s0022-3476(74)80617-7. [DOI] [PubMed] [Google Scholar]
- Sutow W. W., Breslow N. E., Palmer N. F., D'Angio G. J., Takashima J. Prognosis in children with Wilms' tumor metastases prior to or following primary treatment: results from the first National Wilms' Tumor Study (NWTS-1). Am J Clin Oncol. 1982 Aug;5(4):339–347. doi: 10.1097/00000421-198208000-00001. [DOI] [PubMed] [Google Scholar]
- Weeks D. A., Beckwith J. B., Luckey D. W. Relapse-associated variables in stage I favorable histology Wilms' tumor. A report of the National Wilms' Tumor Study. Cancer. 1987 Sep 15;60(6):1204–1212. doi: 10.1002/1097-0142(19870915)60:6<1204::aid-cncr2820600608>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
- Willemse P. H., de Jong P. E., Elema J. D., Mulder N. H. Severe renal failure following high-dose ifosfamide and mesna. Cancer Chemother Pharmacol. 1989;23(5):329–330. doi: 10.1007/BF00292414. [DOI] [PubMed] [Google Scholar]
- de Kraker J., Voûte P. A. Ifosfamide, mesna and vincristine in paediatric oncology. Cancer Treat Rev. 1983 Sep;10 (Suppl A):165–166. doi: 10.1016/s0305-7372(83)80024-3. [DOI] [PubMed] [Google Scholar]
