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Outcomes of non-anaplastic stage III and ‘inoperable’ Wilms tumour treated in the UKW3 trial

Irtan, Sabine; Messahel, Boo; Moroz, Veronica; Taylor, Roger E.; Grundy, Richard; Kelsey, Anna; Vujanic, Gordan; Pritchard-Jones, Kathy

Authors

Sabine Irtan

Boo Messahel

Veronica Moroz

Roger E. Taylor

RICHARD GRUNDY richard.grundy@nottingham.ac.uk
Professor of Paediatric Neuro-Oncology

Anna Kelsey

Gordan Vujanic

Kathy Pritchard-Jones



Abstract

© 2018 Background and purpose: To describe the outcome of patients with stage III Wilms tumours (WT) treated in the UKW3 trial. Material and methods: Patients with a pathologically confirmed stage III non-anaplastic WT at nephrectomy (Group A) or with an ‘inoperable’ tumour at diagnosis managed by biopsy and pre-operative chemotherapy (Actinomycin D-Vincristine-Doxorubicin) but stage I or II at subsequent nephrectomy (Group B) were included. Results: The 4-year overall (OS)/event free survival (EFS) for Group A (n = 117) patients was 90%(95%CI:83–94)/81%(CI:73–87) and for Group B (n = 32) 94%(CI:77–98)/88%(CI:70–95). The 4-year OS/EFS of patients with pathological stage III WT according to whether they received flank/abdominal radiotherapy (95 patients) or not (37 patients, 22 from UKW3 pooled with 17 patients from UKW2) were 91%(CI:83–95)/82%(CI:73–89), and 84%(CI:67–92)/78%(CI:61–89), respectively. The 4-year OS/EFS for patients having one reason to be stage III versus two or three was 92%(CI:84–96)/83%(CI:73–90) and 85%(CI:70–93)/78%(CI:61–88), respectively. Conclusion: Our findings question the inclusion of biopsy or pre-operative chemotherapy as sole criterion for assigning a tumour stage III. Selected patients with pathological stage III WT can survive without radiotherapy. Whilst cautious interpretation is needed due to the post hoc nature of these analyses, further biological studies may better characterise those who could benefit from reduced therapy.

Citation

Irtan, S., Messahel, B., Moroz, V., Taylor, R. E., Grundy, R., Kelsey, A., …Pritchard-Jones, K. (2019). Outcomes of non-anaplastic stage III and ‘inoperable’ Wilms tumour treated in the UKW3 trial. Radiotherapy and Oncology, 131, 1-7. https://doi.org/10.1016/j.radonc.2018.10.026

Journal Article Type Article
Acceptance Date Oct 23, 2018
Online Publication Date Dec 15, 2018
Publication Date Feb 1, 2019
Deposit Date Jun 6, 2019
Publicly Available Date Mar 29, 2024
Journal Radiotherapy and Oncology
Print ISSN 0167-8140
Electronic ISSN 1879-0887
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 131
Pages 1-7
DOI https://doi.org/10.1016/j.radonc.2018.10.026
Public URL https://nottingham-repository.worktribe.com/output/2151250
Publisher URL https://www.sciencedirect.com/science/article/pii/S0167814018335503
Additional Information This article is maintained by: Elsevier; Article Title: Outcomes of non-anaplastic stage III and ‘inoperable’ Wilms tumour treated in the UKW3 trial; Journal Title: Radiotherapy and Oncology; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.radonc.2018.10.026; Content Type: article; Copyright: © 2018 Published by Elsevier B.V.