Please use this identifier to cite or link to this item: doi:10.22028/D291-33558
Title: Outcome of Stage IV Completely Necrotic Wilms Tumour and Local Stage III Treated According to the SIOP 2001 Protocol
Author(s): Davila Fajardo, Raquel
Furtwängler, Rhoikos
van Grotel, Martine
van Tinteren, Harm
Pasqualini, Claudia
Pritchard-Jones, Kathy
Al-Saadi, Reem
de Camargo, Beatriz
Ramírez Villar, Gema L.
Graf, Norbert
Muracciole, Xavier
Melchior, Patrick
Saunders, Daniel
Rübe, Christian
van den Heuvel-Eibrink, Marry M.
Janssens, Geert O.
Verschuur, Arnauld C.
Language: English
Title: Cancers
Volume: 13
Issue: 5
Publisher/Platform: MDPI
Year of Publication: 2021
Free key words: Wilms tumour
completely necrotic
metastatic disease
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Objective: Wilms tumour (WT) patients with a localised completely necrotic nephroblastoma after preoperative chemotherapy are a favourable outcome group. Since the introduction of the SIOP 2001 protocol, the SIOP– Renal Tumour Study Group (SIOP–RTSG) has omitted radiotherapy for such patients with low-risk, local stage III in an attempt to reduce treatment burden. However, for metastatic patients with local stage III, completely necrotic WT, the recommendations led to ambiguous use. The purpose of this descriptive study is to demonstrate the outcomes of patients with metastatic, completely necrotic and local stage III WT in relation to the application of radiotherapy or not. Methods and materials: all metastatic patients with local stage III, completely necrotic WT after 6 weeks of preoperative chemotherapy who were registered in the SIOP 2001 study were included in this analysis. The pattern of recurrence according to the usage of radiation treatment and 5 year event-free survival (EFS) and overall survival (OS) was analysed. Results: seven hundred and three metastatic WT patients were registered in the SIOP 2001 database. Of them, 47 patients had a completely necrotic, local stage III WT: 45 lung metastases (11 combined localisations), 1 liver/peritoneal, and 1 tumour thrombus in the renal vein and the inferior vena cava with bilateral pulmonary arterial embolism. Abdominal radiotherapy was administered in 29 patients (62%; 29 flank/abdominal irradiation and 9 combined with lung irradiation). Eighteen patients did not receive radiotherapy. Median follow-up was 6.6 years (range 1–151 months). Two of the 47 patients (4%) developed disease recurrence in the lung (one combined with abdominal relapse) and eventually died of the disease. Both patients had received abdominal radiotherapy, one of them combined with lung irradiation. Five-year EFS and OS were 95% and 95%, respectively. Conclusions: the outcome of patients with stage IV, local stage III, completely necrotic Wilms tumours is excellent. Our results suggest that abdominal irradiation in this patient category may not be of added value in first-line treatment, consistent with the current recommendation in the SIOP–RTSG 2016 UMBRELLA protocol.
DOI of the first publication: 10.3390/cancers13050976
Link to this record: urn:nbn:de:bsz:291--ds-335581
ISSN: 2072-6694
Date of registration: 15-Mar-2021
Description of the related object: Supplementary Materials
Related object:
Faculty: M - Medizinische Fakultät
Department: M - Pädiatrie
M - Radiologie
Professorship: M - Prof. Dr. Norbert Graf
M - Prof. Dr. Christian Rübe
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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