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Age is not a prognostic factor in children with Wilms tumor beyond stage I in Africa
Author(s) -
Aronson D.C.,
Hadley G.P.
Publication year - 2014
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24948
Subject(s) - medicine , wilms' tumor , stage (stratigraphy) , histology , cohort , anaplasia , pediatrics , pathology , paleontology , biology
Background Patients under age 4 with stage I favorable histology (FH) Wilms tumor have a reported survival advantage. Among children above 10 years, a poorer prognosis has been associated with a higher prevalence of diffuse anaplasia. Purpose : To determine if, in our practice, patients with Wilms tumors >8 years of age (stage II–V) have a poorer prognosis than those aged <8 years or <4 years. Procedure Case‐control study of 19 patients >8 years with Wilms tumor stages II–V who were identified from a cohort of 192 new patients (2002–2012). For each patient two controls were chosen matched for stage and histology, one 0–3 years and one 4–7 years. Neo‐adjuvant chemotherapy was offered to all, combined with intensive supportive care. Postoperative treatment was determined by local stage and histology. OS and EFS at 5 years for the different age groups were compared. Results Each age group contained 19 patients, of whom 6 had stage II tumors, 3 stage III, 8 stage IV, and 2 stage V. Histology was intermediate risk (IR) in 17 and high risk (HR) in 2. OS at 5 years was 80.8% and EFS was 79.2% for the whole group. No significant difference in outcome could be shown between age groups. Loss to follow up was 6/57 (11%). Conclusions The survival advantage of young age (<4 years) associated with stage I FH could not be demonstrated in higher stages. Age had no significant impact on prognosis although a trend to better outcome was seen in children <4 years. Pediatr Blood Cancer 2014;61:987–989. © 2014 Wiley Periodicals, Inc.