Hol, J ALopez-Yurda, M IVan Tinteren, HVan Grotel, MGodzinski, JVujanic, GOldenburger, FDe Camargo, BRamírez-Villar, G LBergeron, CPritchard-Jones, KGraf, NVan den Heuvel-Eibrink, M M2023-01-252023-01-252019-08-19http://hdl.handle.net/10668/14409To 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.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/AdolescentAge FactorsAntineoplastic Combined Chemotherapy ProtocolsChemotherapy, AdjuvantChildChild, PreschoolDisease-Free SurvivalFemaleHumansInfantKidneyKidney NeoplasmsMaleNeoplasm StagingNephrectomyPatient SelectionPrognosisProspective StudiesRisk AssessmentRisk FactorsTumor BurdenWilms Tumorresearch article31425556open access10.1371/journal.pone.02213731932-6203PMC6699693https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0221373&type=printablehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6699693/pdf