Treatment of anaplastic histology Wilms' tumor

Results from the fifth National Wilms' Tumor Study

Jeffrey S. Dome, Cecilia A. Cotton, Elizabeth J. Perlman, Norman E. Breslow, John A. Kalapurakal, Michael L. Ritchey, Paul E. Grundy, Marcio Malogolowkin, J. Bruce Beckwith, Robert C. Shamberger, Gerald M. Haase, Max J. Coppes, Peter Coccia, Morris Kletzel, Robert M. Weetman, Milton Donaldson, Roger M. Macklis, Daniel M. Green

Research output: Contribution to journalArticle

173 Citations (Scopus)

Abstract

Purpose: An objective of the fifth National Wilms' Tumor Study (NWTS-5) was to evaluate the efficacy of treatment regimens for anaplastic histology Wilms' tumor (AH). Patients and Methods: Prospective single-arm studies were conducted. Patients with stage I AH were treated with vincristine and dactinomycin for 18 weeks. Patients with stages II to IV diffuse AH were treated with vincristine, doxorubicin, cyclophosphamide, and etoposide for 24 weeks plus flank/abdominal radiation. Results: A total of 2,596 patients with Wilms' tumor were enrolled onto NWTS-5, of whom 281 (10.8%) had AH. Four-year event-free survival (EFS) and overall survival (OS) estimates for assessable patients with stage I AH (n = 29) were 69.5% (95% CI, 46.9 to 84.0) and 82.6% (95% CI, 63.1 to 92.4). In comparison, 4-year EFS and OS estimates for patients with stage I favorable histology (FH; n = 473) were 92.4% (95% CI, 89.5 to 94.5) and 98.3% (95% CI, 96.4 to 99.2). Four-year EFS estimates for patients who underwent immediate nephrectomy with stages II (n = 23), III (n = 43), and IV (n = 15) diffuse AH were 82.6% (95% CI, 60.1 to 93.1), 64.7% (95% CI, 48.3 to 77.7), and 33.3% (95% CI, 12.2 to 56.4), respectively. OS was similar to EFS for these groups. There were no local recurrences among patients with stage II AH. Four-year EFS and OS estimates for patients with bilateral AH (n = 29) were 43.8% (95% CI, 24.2 to 61.8) and 55.2% (95% CI, 34.8 to 71.7), respectively. Conclusion: The prognosis for patients with stage I AH is worse than that for patients with stage I FH. Novel treatment strategies are needed to improve outcomes for patients with AH, especially those with stage III to V disease.

Original languageEnglish (US)
Pages (from-to)2352-2358
Number of pages7
JournalJournal of Clinical Oncology
Volume24
Issue number15
DOIs
StatePublished - May 20 2006
Externally publishedYes

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Wilms Tumor
Histology
Disease-Free Survival
Therapeutics
Survival
Vincristine
Dactinomycin
Etoposide
Nephrectomy
Doxorubicin
Cyclophosphamide

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Dome, J. S., Cotton, C. A., Perlman, E. J., Breslow, N. E., Kalapurakal, J. A., Ritchey, M. L., ... Green, D. M. (2006). Treatment of anaplastic histology Wilms' tumor: Results from the fifth National Wilms' Tumor Study. Journal of Clinical Oncology, 24(15), 2352-2358. https://doi.org/10.1200/JCO.2005.04.7852

Treatment of anaplastic histology Wilms' tumor : Results from the fifth National Wilms' Tumor Study. / Dome, Jeffrey S.; Cotton, Cecilia A.; Perlman, Elizabeth J.; Breslow, Norman E.; Kalapurakal, John A.; Ritchey, Michael L.; Grundy, Paul E.; Malogolowkin, Marcio; Beckwith, J. Bruce; Shamberger, Robert C.; Haase, Gerald M.; Coppes, Max J.; Coccia, Peter; Kletzel, Morris; Weetman, Robert M.; Donaldson, Milton; Macklis, Roger M.; Green, Daniel M.

In: Journal of Clinical Oncology, Vol. 24, No. 15, 20.05.2006, p. 2352-2358.

Research output: Contribution to journalArticle

Dome, JS, Cotton, CA, Perlman, EJ, Breslow, NE, Kalapurakal, JA, Ritchey, ML, Grundy, PE, Malogolowkin, M, Beckwith, JB, Shamberger, RC, Haase, GM, Coppes, MJ, Coccia, P, Kletzel, M, Weetman, RM, Donaldson, M, Macklis, RM & Green, DM 2006, 'Treatment of anaplastic histology Wilms' tumor: Results from the fifth National Wilms' Tumor Study', Journal of Clinical Oncology, vol. 24, no. 15, pp. 2352-2358. https://doi.org/10.1200/JCO.2005.04.7852
Dome JS, Cotton CA, Perlman EJ, Breslow NE, Kalapurakal JA, Ritchey ML et al. Treatment of anaplastic histology Wilms' tumor: Results from the fifth National Wilms' Tumor Study. Journal of Clinical Oncology. 2006 May 20;24(15):2352-2358. https://doi.org/10.1200/JCO.2005.04.7852
Dome, Jeffrey S. ; Cotton, Cecilia A. ; Perlman, Elizabeth J. ; Breslow, Norman E. ; Kalapurakal, John A. ; Ritchey, Michael L. ; Grundy, Paul E. ; Malogolowkin, Marcio ; Beckwith, J. Bruce ; Shamberger, Robert C. ; Haase, Gerald M. ; Coppes, Max J. ; Coccia, Peter ; Kletzel, Morris ; Weetman, Robert M. ; Donaldson, Milton ; Macklis, Roger M. ; Green, Daniel M. / Treatment of anaplastic histology Wilms' tumor : Results from the fifth National Wilms' Tumor Study. In: Journal of Clinical Oncology. 2006 ; Vol. 24, No. 15. pp. 2352-2358.
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title = "Treatment of anaplastic histology Wilms' tumor: Results from the fifth National Wilms' Tumor Study",
abstract = "Purpose: An objective of the fifth National Wilms' Tumor Study (NWTS-5) was to evaluate the efficacy of treatment regimens for anaplastic histology Wilms' tumor (AH). Patients and Methods: Prospective single-arm studies were conducted. Patients with stage I AH were treated with vincristine and dactinomycin for 18 weeks. Patients with stages II to IV diffuse AH were treated with vincristine, doxorubicin, cyclophosphamide, and etoposide for 24 weeks plus flank/abdominal radiation. Results: A total of 2,596 patients with Wilms' tumor were enrolled onto NWTS-5, of whom 281 (10.8{\%}) had AH. Four-year event-free survival (EFS) and overall survival (OS) estimates for assessable patients with stage I AH (n = 29) were 69.5{\%} (95{\%} CI, 46.9 to 84.0) and 82.6{\%} (95{\%} CI, 63.1 to 92.4). In comparison, 4-year EFS and OS estimates for patients with stage I favorable histology (FH; n = 473) were 92.4{\%} (95{\%} CI, 89.5 to 94.5) and 98.3{\%} (95{\%} CI, 96.4 to 99.2). Four-year EFS estimates for patients who underwent immediate nephrectomy with stages II (n = 23), III (n = 43), and IV (n = 15) diffuse AH were 82.6{\%} (95{\%} CI, 60.1 to 93.1), 64.7{\%} (95{\%} CI, 48.3 to 77.7), and 33.3{\%} (95{\%} CI, 12.2 to 56.4), respectively. OS was similar to EFS for these groups. There were no local recurrences among patients with stage II AH. Four-year EFS and OS estimates for patients with bilateral AH (n = 29) were 43.8{\%} (95{\%} CI, 24.2 to 61.8) and 55.2{\%} (95{\%} CI, 34.8 to 71.7), respectively. Conclusion: The prognosis for patients with stage I AH is worse than that for patients with stage I FH. Novel treatment strategies are needed to improve outcomes for patients with AH, especially those with stage III to V disease.",
author = "Dome, {Jeffrey S.} and Cotton, {Cecilia A.} and Perlman, {Elizabeth J.} and Breslow, {Norman E.} and Kalapurakal, {John A.} and Ritchey, {Michael L.} and Grundy, {Paul E.} and Marcio Malogolowkin and Beckwith, {J. Bruce} and Shamberger, {Robert C.} and Haase, {Gerald M.} and Coppes, {Max J.} and Peter Coccia and Morris Kletzel and Weetman, {Robert M.} and Milton Donaldson and Macklis, {Roger M.} and Green, {Daniel M.}",
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T1 - Treatment of anaplastic histology Wilms' tumor

T2 - Results from the fifth National Wilms' Tumor Study

AU - Dome, Jeffrey S.

AU - Cotton, Cecilia A.

AU - Perlman, Elizabeth J.

AU - Breslow, Norman E.

AU - Kalapurakal, John A.

AU - Ritchey, Michael L.

AU - Grundy, Paul E.

AU - Malogolowkin, Marcio

AU - Beckwith, J. Bruce

AU - Shamberger, Robert C.

AU - Haase, Gerald M.

AU - Coppes, Max J.

AU - Coccia, Peter

AU - Kletzel, Morris

AU - Weetman, Robert M.

AU - Donaldson, Milton

AU - Macklis, Roger M.

AU - Green, Daniel M.

PY - 2006/5/20

Y1 - 2006/5/20

N2 - Purpose: An objective of the fifth National Wilms' Tumor Study (NWTS-5) was to evaluate the efficacy of treatment regimens for anaplastic histology Wilms' tumor (AH). Patients and Methods: Prospective single-arm studies were conducted. Patients with stage I AH were treated with vincristine and dactinomycin for 18 weeks. Patients with stages II to IV diffuse AH were treated with vincristine, doxorubicin, cyclophosphamide, and etoposide for 24 weeks plus flank/abdominal radiation. Results: A total of 2,596 patients with Wilms' tumor were enrolled onto NWTS-5, of whom 281 (10.8%) had AH. Four-year event-free survival (EFS) and overall survival (OS) estimates for assessable patients with stage I AH (n = 29) were 69.5% (95% CI, 46.9 to 84.0) and 82.6% (95% CI, 63.1 to 92.4). In comparison, 4-year EFS and OS estimates for patients with stage I favorable histology (FH; n = 473) were 92.4% (95% CI, 89.5 to 94.5) and 98.3% (95% CI, 96.4 to 99.2). Four-year EFS estimates for patients who underwent immediate nephrectomy with stages II (n = 23), III (n = 43), and IV (n = 15) diffuse AH were 82.6% (95% CI, 60.1 to 93.1), 64.7% (95% CI, 48.3 to 77.7), and 33.3% (95% CI, 12.2 to 56.4), respectively. OS was similar to EFS for these groups. There were no local recurrences among patients with stage II AH. Four-year EFS and OS estimates for patients with bilateral AH (n = 29) were 43.8% (95% CI, 24.2 to 61.8) and 55.2% (95% CI, 34.8 to 71.7), respectively. Conclusion: The prognosis for patients with stage I AH is worse than that for patients with stage I FH. Novel treatment strategies are needed to improve outcomes for patients with AH, especially those with stage III to V disease.

AB - Purpose: An objective of the fifth National Wilms' Tumor Study (NWTS-5) was to evaluate the efficacy of treatment regimens for anaplastic histology Wilms' tumor (AH). Patients and Methods: Prospective single-arm studies were conducted. Patients with stage I AH were treated with vincristine and dactinomycin for 18 weeks. Patients with stages II to IV diffuse AH were treated with vincristine, doxorubicin, cyclophosphamide, and etoposide for 24 weeks plus flank/abdominal radiation. Results: A total of 2,596 patients with Wilms' tumor were enrolled onto NWTS-5, of whom 281 (10.8%) had AH. Four-year event-free survival (EFS) and overall survival (OS) estimates for assessable patients with stage I AH (n = 29) were 69.5% (95% CI, 46.9 to 84.0) and 82.6% (95% CI, 63.1 to 92.4). In comparison, 4-year EFS and OS estimates for patients with stage I favorable histology (FH; n = 473) were 92.4% (95% CI, 89.5 to 94.5) and 98.3% (95% CI, 96.4 to 99.2). Four-year EFS estimates for patients who underwent immediate nephrectomy with stages II (n = 23), III (n = 43), and IV (n = 15) diffuse AH were 82.6% (95% CI, 60.1 to 93.1), 64.7% (95% CI, 48.3 to 77.7), and 33.3% (95% CI, 12.2 to 56.4), respectively. OS was similar to EFS for these groups. There were no local recurrences among patients with stage II AH. Four-year EFS and OS estimates for patients with bilateral AH (n = 29) were 43.8% (95% CI, 24.2 to 61.8) and 55.2% (95% CI, 34.8 to 71.7), respectively. Conclusion: The prognosis for patients with stage I AH is worse than that for patients with stage I FH. Novel treatment strategies are needed to improve outcomes for patients with AH, especially those with stage III to V disease.

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