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Prognostic significance of age in 5631 patients with Wilms tumour prospectively registered in International Society of Paediatric Oncology (SIOP) 93-01 and 2001.

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PMC6699693.pdf (1.41 MB)
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URI: http://hdl.handle.net/10668/14409
DOI: 10.1371/journal.pone.0221373
Date
2019-08-19
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To enhance risk stratification for Wilms tumour (WT) in a pre-operative chemotherapy setting, we explored the prognostic significance and optimal age cutoffs in patients treated according to International Society of Paediatric Oncology Renal Tumour Study Group (SIOP-RTSG) protocols. Patients(6 months-18 years) with unilateral WT were selected from prospective SIOP 93-01 and 2001 studies(1993-2016). Martingale residual analysis was used to explore optimal age cutoffs. Outcome according to age was analyzed by uni- and multivariable analysis, adjusted for sex, biopsy(yes/no), stage, histology and tumour volume at surgery. 5631 patients were included; median age was 3.4 years(IQR: 2-5.1). Estimated 5-year event-free survival (EFS) and overall survival (OS) were 85%(95%CI 83.5-85.5) and 93%(95%CI 92.0-93.4). Martingale residual plots detected no optimal age cutoffs. Multivariable analysis showed lower EFS with increasing age(linear trend P Although optimal age cutoffs could not be identified, we demonstrated the prognostic significance of age as well as previously described cutoffs for EFS (2 and 4 years) and OS (4 years) in children with WT treated with pre-operative chemotherapy. These findings encourage the consideration of age in the design of future SIOP-RTSG protocols.
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Adolescent
Age Factors
Antineoplastic Combined Chemotherapy Protocols
Chemotherapy, Adjuvant
Child
Child, Preschool
Disease-Free Survival
Female
Humans
Infant
Kidney
Kidney Neoplasms
Male
Neoplasm Staging
Nephrectomy
Patient Selection
Prognosis
Prospective Studies
Risk Assessment
Risk Factors
Tumor Burden
Wilms Tumor
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http://hdl.handle.net/10668/14409
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