Table 2.
Treatment modalities and outcome of bilateral WT patients
| AEIOP (Ref. 59) | SFCE (Ref. 64) | NWTS (Ref. 58) | JPLT (Ref. 62) | GPOH/SIOP9 (Ref. 65) | UKW2 (Ref. 60) | Netherlands (Ref. 56) | Egypt (Ref. 63) | Durban (Ref. 57) | Cape Town (Ref. 61) | |
|---|---|---|---|---|---|---|---|---|---|---|
| Number of patients/kidneys | 93/176 | 49/94 | 188/376 | 31/56 | 28/ | 70/114 | 25/ | 22/ | 20/37 | 19/ |
| Preop CT | 43 VA 37 VAD 1 +Ifo + Carbo 6 primary surgery |
VA 10 1st line 6 2nd line (add D or E + C) 4 3rd line |
83 primary surgery | 11 EE4A 13 DD4A 9 modif (upgrade EE to DD, add C + Carbo) 7 primary surgery |
28 VA | 13 primary surgery | SIOP protocols since 1971 | 6 primary surgery 10 VA 6 VAD |
10 VA 4 VAD 5 VA*3 1 VA + E + Ifo + cisplat |
3 VA 11 VAD 1 VADC 4 VADCE |
| Duration preop CT | 12 weeks (1–40) | 80 days (47–89) | 14.2 weeks (8–24) | |||||||
| Histology | ||||||||||
| Stage 1 | 25 (27%) | 19 (40%) | 63 (17%) | 15 (54%) | 11 (50%) | 6 (32%) | ||||
| Stage 2 | 26 (28%) | 14 (30%) | 215 (57%) | 2 (7%) | 11 (50%) | 12 (63%) | ||||
| Stage 3 | 28 (30%) | 14 (30%) | 73 (19%) | 11 (39%) | 0 | 6? | 1 (5%) | |||
| No stage | 14 (15%) | 2 | 12 (7%) | 0 | 0 | |||||
| Low risk | With IR | 16 (15%) | ? | 1 | With IR | 1 (5%) | ||||
| Intermediate risk | 67 (76%) | 78 (83%) | 78 (29%) | 27 | 17 (77%) | 8 (42%) | ||||
| High risk (Blastema only) | 8 (9%) | 0 | 17 (7%) | 0 | 7 (10%) | 5 (23%) | 9 (47%) | 8 (42%) | ||
| Diffuse Anaplasia | 10 (12%) | 2 (2%) | 16 (6%) | 0 | 0 | With above | With above | With above | 2 (11%) | |
| NR | 37 Kidneys (39%) | 17 Kidneys (5.5%) | 21 (30%) | 18 (95%) | ||||||
| Postop CT | 4 no postop CT (no response to preop CT) 18 VA 22 VAD 4 VA + other drugs |
EE4A DD4A 2nd line in 87 (46%) |
Stage 2 regimen | 59 VAD 5 VA + C 5 VA 1 V |
10 VA 7 VAD 4 VAD + Ifo + Eto 1 died at preop phase |
|||||
| Radiotherapy | 20 (22%) | 11 (22%) | 64 (34%) | 4 (13%) | 21 (30%) | 5 (20%) | 0 | 13 (65%) | 2 (11%) | |
| Relapse | 27 (29%) | 7 (14%) | 54 (28%) | (13%) | (18%) | 16 (23%) | 1 (4.5%) | 2 (10%) | 6 (32%) | |
| OS/EFS | 80%/66.5% (4y) | 89%/83% (5y) | 84%/70% (8y) | 93%/85% (5y) | 85%/80% | 69% (6y) | 75.6% (20y) | 61% (3y) | 85% (2y) | 51.6%/29.2% (5y) for S 80%/80% (5y) for Me |
| ESRD | At least 1 (1%) | 7 (14%) | 23 (12%) | 4 (13%) | 5 (7%) | 8 (32%) | 1 (5%) | 2 (10%) | 2 (11%) |
CT, chemotherapy; V, vincristine; A, Actinomycin D; D, doxorubicin; C, cyclophosphamide; E, etoposide; Ifo, ifosfamide; carbo, carboplatin; cisplat, cisplatine; ESRD, end-stage renal disease; NR, nephrogenic rests; S, synchronous; Me, metachronous.