Prognostic significance of histopathological response to preoperative chemotherapy in unilateral Wilms' tumor: An analysis of 899 patients treated on the SIOP WT 2001 protocol in the UK‐CCLG and GPOH studies

<p dir="ltr">In the SIOP Wilms' tumor (WT) studies, preoperative chemotherapy is used as primary treatment, and tumors are classified thereafter by pathologists. Completely necrotic WTs (CN-WTs) are classified as low-risk tumors. The aim of the study was to evaluate whether a su...

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Main Author: Gordan M. Vujanić (14778694) (author)
Other Authors: Ellen D'Hooghe (14778697) (author), Norbert Graf (106033) (author), Christian Vokuhl (3561299) (author), Reem Al‐Saadi (14778700) (author), Tanzina Chowdhury (3591140) (author), Kathy Pritchard‐Jones (14778703) (author), Rhoikos Furtwängler (538274) (author)
Published: 2021
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_version_ 1864513555829620736
author Gordan M. Vujanić (14778694)
author2 Ellen D'Hooghe (14778697)
Norbert Graf (106033)
Christian Vokuhl (3561299)
Reem Al‐Saadi (14778700)
Tanzina Chowdhury (3591140)
Kathy Pritchard‐Jones (14778703)
Rhoikos Furtwängler (538274)
author2_role author
author
author
author
author
author
author
author_facet Gordan M. Vujanić (14778694)
Ellen D'Hooghe (14778697)
Norbert Graf (106033)
Christian Vokuhl (3561299)
Reem Al‐Saadi (14778700)
Tanzina Chowdhury (3591140)
Kathy Pritchard‐Jones (14778703)
Rhoikos Furtwängler (538274)
author_role author
dc.creator.none.fl_str_mv Gordan M. Vujanić (14778694)
Ellen D'Hooghe (14778697)
Norbert Graf (106033)
Christian Vokuhl (3561299)
Reem Al‐Saadi (14778700)
Tanzina Chowdhury (3591140)
Kathy Pritchard‐Jones (14778703)
Rhoikos Furtwängler (538274)
dc.date.none.fl_str_mv 2021-06-10T06:00:00Z
dc.identifier.none.fl_str_mv 10.1002/ijc.33707
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Prognostic_significance_of_histopathological_response_to_preoperative_chemotherapy_in_unilateral_Wilms_tumor_An_analysis_of_899_patients_treated_on_the_SIOP_WT_2001_protocol_in_the_UK_CCLG_and_GPOH_studies/22258195
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Oncology and carcinogenesis
preoperative chemotherapy
prognosis
response
Wilms' tumor
dc.title.none.fl_str_mv Prognostic significance of histopathological response to preoperative chemotherapy in unilateral Wilms' tumor: An analysis of 899 patients treated on the SIOP WT 2001 protocol in the UK‐CCLG and GPOH studies
dc.type.none.fl_str_mv Text
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info:eu-repo/semantics/publishedVersion
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description <p dir="ltr">In the SIOP Wilms' tumor (WT) studies, preoperative chemotherapy is used as primary treatment, and tumors are classified thereafter by pathologists. Completely necrotic WTs (CN-WTs) are classified as low-risk tumors. The aim of the study was to evaluate whether a subset of regressive type WTs (RT-WTs) (67%-99% chemotherapy-induced changes [CIC]) showing an exceptionally good response to preoperative chemotherapy had comparably excellent survivals as CN-WTs, and to establish a cut-off point of CIC that could define this subset. The study included 2117 patients with unilateral, nonanaplastic WTs from the UK-CCLG and GPOH-WT studies (2001-2020) treated according to the SIOP-WT-2001 protocol. There were 126 patients with CN-WTs and 773 with RT-WTs, stages I-IV. RT-WTs were subdivided into subtotally necrotic WTs (>95% CIC) (STN-WT96-99) (124 patients) and the remaining of RT-WT (RR-WT67-95) (649 patients). The 5-year event-free survival (EFS) and overall survival (OS) for CN-WTs were 95.3% (±2.1% SE) and 97.3% (±1.5% SE), and for RT-WTs 85.7% (±1.14% SE, <i>P</i> < .01) and 95.2% (±0.01% SE, <i>P</i> = .59), respectively. CN-WT and STN-WT96-99 groups showed significantly better EFS than RR-WT67-95 (<i>P</i> = .003 and <i>P</i> = .02, respectively), which remained significantly superior when adjusted for age, local stage and metastasis at diagnosis, in multivariate analysis, whereas OS were superimposable (97.3 ± 1.5% SE for CN-WT; 97.8 ± 1.5% SE for STN-WT96-99; 94.7 ± 1.0% SE for RR-WT67-95). Patients with STN-WT96-99 share the same excellent EFS and OS as patients with CN-WTs, and although this was achieved by more treatment for patients with STN-WT96-99 than for patients with CN-WT, reduction in postoperative treatment of these patients may be justified.</p><h2>Other Information</h2><p dir="ltr">Published in: International Journal of Cancer<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1002/ijc.33707" target="_blank">http://dx.doi.org/10.1002/ijc.33707</a></p>
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identifier_str_mv 10.1002/ijc.33707
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/22258195
publishDate 2021
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rights_invalid_str_mv CC BY 4.0
spelling Prognostic significance of histopathological response to preoperative chemotherapy in unilateral Wilms' tumor: An analysis of 899 patients treated on the SIOP WT 2001 protocol in the UK‐CCLG and GPOH studiesGordan M. Vujanić (14778694)Ellen D'Hooghe (14778697)Norbert Graf (106033)Christian Vokuhl (3561299)Reem Al‐Saadi (14778700)Tanzina Chowdhury (3591140)Kathy Pritchard‐Jones (14778703)Rhoikos Furtwängler (538274)Biomedical and clinical sciencesOncology and carcinogenesispreoperative chemotherapyprognosisresponseWilms' tumor<p dir="ltr">In the SIOP Wilms' tumor (WT) studies, preoperative chemotherapy is used as primary treatment, and tumors are classified thereafter by pathologists. Completely necrotic WTs (CN-WTs) are classified as low-risk tumors. The aim of the study was to evaluate whether a subset of regressive type WTs (RT-WTs) (67%-99% chemotherapy-induced changes [CIC]) showing an exceptionally good response to preoperative chemotherapy had comparably excellent survivals as CN-WTs, and to establish a cut-off point of CIC that could define this subset. The study included 2117 patients with unilateral, nonanaplastic WTs from the UK-CCLG and GPOH-WT studies (2001-2020) treated according to the SIOP-WT-2001 protocol. There were 126 patients with CN-WTs and 773 with RT-WTs, stages I-IV. RT-WTs were subdivided into subtotally necrotic WTs (>95% CIC) (STN-WT96-99) (124 patients) and the remaining of RT-WT (RR-WT67-95) (649 patients). The 5-year event-free survival (EFS) and overall survival (OS) for CN-WTs were 95.3% (±2.1% SE) and 97.3% (±1.5% SE), and for RT-WTs 85.7% (±1.14% SE, <i>P</i> < .01) and 95.2% (±0.01% SE, <i>P</i> = .59), respectively. CN-WT and STN-WT96-99 groups showed significantly better EFS than RR-WT67-95 (<i>P</i> = .003 and <i>P</i> = .02, respectively), which remained significantly superior when adjusted for age, local stage and metastasis at diagnosis, in multivariate analysis, whereas OS were superimposable (97.3 ± 1.5% SE for CN-WT; 97.8 ± 1.5% SE for STN-WT96-99; 94.7 ± 1.0% SE for RR-WT67-95). Patients with STN-WT96-99 share the same excellent EFS and OS as patients with CN-WTs, and although this was achieved by more treatment for patients with STN-WT96-99 than for patients with CN-WT, reduction in postoperative treatment of these patients may be justified.</p><h2>Other Information</h2><p dir="ltr">Published in: International Journal of Cancer<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1002/ijc.33707" target="_blank">http://dx.doi.org/10.1002/ijc.33707</a></p>2021-06-10T06:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1002/ijc.33707https://figshare.com/articles/journal_contribution/Prognostic_significance_of_histopathological_response_to_preoperative_chemotherapy_in_unilateral_Wilms_tumor_An_analysis_of_899_patients_treated_on_the_SIOP_WT_2001_protocol_in_the_UK_CCLG_and_GPOH_studies/22258195CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/222581952021-06-10T06:00:00Z
spellingShingle Prognostic significance of histopathological response to preoperative chemotherapy in unilateral Wilms' tumor: An analysis of 899 patients treated on the SIOP WT 2001 protocol in the UK‐CCLG and GPOH studies
Gordan M. Vujanić (14778694)
Biomedical and clinical sciences
Oncology and carcinogenesis
preoperative chemotherapy
prognosis
response
Wilms' tumor
status_str publishedVersion
title Prognostic significance of histopathological response to preoperative chemotherapy in unilateral Wilms' tumor: An analysis of 899 patients treated on the SIOP WT 2001 protocol in the UK‐CCLG and GPOH studies
title_full Prognostic significance of histopathological response to preoperative chemotherapy in unilateral Wilms' tumor: An analysis of 899 patients treated on the SIOP WT 2001 protocol in the UK‐CCLG and GPOH studies
title_fullStr Prognostic significance of histopathological response to preoperative chemotherapy in unilateral Wilms' tumor: An analysis of 899 patients treated on the SIOP WT 2001 protocol in the UK‐CCLG and GPOH studies
title_full_unstemmed Prognostic significance of histopathological response to preoperative chemotherapy in unilateral Wilms' tumor: An analysis of 899 patients treated on the SIOP WT 2001 protocol in the UK‐CCLG and GPOH studies
title_short Prognostic significance of histopathological response to preoperative chemotherapy in unilateral Wilms' tumor: An analysis of 899 patients treated on the SIOP WT 2001 protocol in the UK‐CCLG and GPOH studies
title_sort Prognostic significance of histopathological response to preoperative chemotherapy in unilateral Wilms' tumor: An analysis of 899 patients treated on the SIOP WT 2001 protocol in the UK‐CCLG and GPOH studies
topic Biomedical and clinical sciences
Oncology and carcinogenesis
preoperative chemotherapy
prognosis
response
Wilms' tumor