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International Comparisons of Clinical Demographics and Outcomes in the International Society of Pediatric Oncology Wilms Tumor 2001 Trial and Study
International comparisons of patient demographics, tumor characteristics, and survival can shed light on areas for health care system improvement. The International Society of Pediatric Oncology Wilms Tumor 2001 trial/study registered patients through national clinical study groups in Western Europe...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9126524/ https://www.ncbi.nlm.nih.gov/pubmed/35537105 http://dx.doi.org/10.1200/GO.21.00425 |
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author | de Aguirre-Neto, Joaquim Caetano de Camargo, Beatriz van Tinteren, Harm Bergeron, Christophe Brok, Jesper Ramírez-Villar, Gema Verschuur, Arnauld Furtwängler, Rhoikos Howell, Lisa Saunders, Daniel Olsen, Oystein Coulomb, Aurore Vokuhl, Christian Godzinski, Jan Smets, Anne M. Vujanic, Gordan M. van den Heuvel-Eibrink, Marry M. Graf, Norbert Pritchard-Jones, Kathy |
author_facet | de Aguirre-Neto, Joaquim Caetano de Camargo, Beatriz van Tinteren, Harm Bergeron, Christophe Brok, Jesper Ramírez-Villar, Gema Verschuur, Arnauld Furtwängler, Rhoikos Howell, Lisa Saunders, Daniel Olsen, Oystein Coulomb, Aurore Vokuhl, Christian Godzinski, Jan Smets, Anne M. Vujanic, Gordan M. van den Heuvel-Eibrink, Marry M. Graf, Norbert Pritchard-Jones, Kathy |
author_sort | de Aguirre-Neto, Joaquim Caetano |
collection | PubMed |
description | International comparisons of patient demographics, tumor characteristics, and survival can shed light on areas for health care system improvement. The International Society of Pediatric Oncology Wilms Tumor 2001 trial/study registered patients through national clinical study groups in Western Europe and Brazil. This retrospective post hoc analysis of the International Society of Pediatric Oncology Wilms Tumor 2001 database aims to make visible and suggest reasons for any variations in outcomes. METHODS: All patients with unilateral Wilms tumor (WT), age > 6 months, treated with preoperative chemotherapy as per protocol, and registered between 2001 and 2011 were eligible. Countries were grouped to give comparable case numbers and geographical representation. Cox univariable and multivariable (MVA) statistics were applied, with the German collaborative group (Gesellschaft für Pädiatrische Onkologie und Hämatologie—Austria, Germany, and Switzerland) as reference for hazard ratios for event-free survival (EFS) and overall survival (OS). RESULTS: A total of 3,176 eligible patients were registered from 24 countries assigned into six groups. Age and histologic risk group distribution were similar across all groupings. The distribution of WT stage varied by country grouping, with 14.9% (range, 11.1%-18.2%) metastatic at diagnosis. Median follow-up was 78.9 months. For localized WT, 5-year EFS varied from 80% (Brazilian group) to 91% (French group; P < .0001), retaining significance only for Brazil in MVA (P = .001). Five-year OS varied from 89% (Brazilian group) to 98% (French group; P < .0001). In MVA, only superior OS in France was significant (P = .001). Five-year EFS/OS for stage IV did not vary significantly. High-risk histology and tumor volume at surgery were significantly associated with increased risk of death in MVA for metastatic disease. CONCLUSION: International benchmarking of survival rates from WT within a large trial/study database has demonstrated statistically significant differences. Clinical interpretation should take account of variation in tumor stage but also treatment factors. |
format | Online Article Text |
id | pubmed-9126524 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-91265242022-05-24 International Comparisons of Clinical Demographics and Outcomes in the International Society of Pediatric Oncology Wilms Tumor 2001 Trial and Study de Aguirre-Neto, Joaquim Caetano de Camargo, Beatriz van Tinteren, Harm Bergeron, Christophe Brok, Jesper Ramírez-Villar, Gema Verschuur, Arnauld Furtwängler, Rhoikos Howell, Lisa Saunders, Daniel Olsen, Oystein Coulomb, Aurore Vokuhl, Christian Godzinski, Jan Smets, Anne M. Vujanic, Gordan M. van den Heuvel-Eibrink, Marry M. Graf, Norbert Pritchard-Jones, Kathy JCO Glob Oncol ORIGINAL REPORTS International comparisons of patient demographics, tumor characteristics, and survival can shed light on areas for health care system improvement. The International Society of Pediatric Oncology Wilms Tumor 2001 trial/study registered patients through national clinical study groups in Western Europe and Brazil. This retrospective post hoc analysis of the International Society of Pediatric Oncology Wilms Tumor 2001 database aims to make visible and suggest reasons for any variations in outcomes. METHODS: All patients with unilateral Wilms tumor (WT), age > 6 months, treated with preoperative chemotherapy as per protocol, and registered between 2001 and 2011 were eligible. Countries were grouped to give comparable case numbers and geographical representation. Cox univariable and multivariable (MVA) statistics were applied, with the German collaborative group (Gesellschaft für Pädiatrische Onkologie und Hämatologie—Austria, Germany, and Switzerland) as reference for hazard ratios for event-free survival (EFS) and overall survival (OS). RESULTS: A total of 3,176 eligible patients were registered from 24 countries assigned into six groups. Age and histologic risk group distribution were similar across all groupings. The distribution of WT stage varied by country grouping, with 14.9% (range, 11.1%-18.2%) metastatic at diagnosis. Median follow-up was 78.9 months. For localized WT, 5-year EFS varied from 80% (Brazilian group) to 91% (French group; P < .0001), retaining significance only for Brazil in MVA (P = .001). Five-year OS varied from 89% (Brazilian group) to 98% (French group; P < .0001). In MVA, only superior OS in France was significant (P = .001). Five-year EFS/OS for stage IV did not vary significantly. High-risk histology and tumor volume at surgery were significantly associated with increased risk of death in MVA for metastatic disease. CONCLUSION: International benchmarking of survival rates from WT within a large trial/study database has demonstrated statistically significant differences. Clinical interpretation should take account of variation in tumor stage but also treatment factors. Wolters Kluwer Health 2022-05-10 /pmc/articles/PMC9126524/ /pubmed/35537105 http://dx.doi.org/10.1200/GO.21.00425 Text en © 2022 by American Society of Clinical Oncology https://creativecommons.org/licenses/by/4.0/Licensed under the Creative Commons Attribution 4.0 License: http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | ORIGINAL REPORTS de Aguirre-Neto, Joaquim Caetano de Camargo, Beatriz van Tinteren, Harm Bergeron, Christophe Brok, Jesper Ramírez-Villar, Gema Verschuur, Arnauld Furtwängler, Rhoikos Howell, Lisa Saunders, Daniel Olsen, Oystein Coulomb, Aurore Vokuhl, Christian Godzinski, Jan Smets, Anne M. Vujanic, Gordan M. van den Heuvel-Eibrink, Marry M. Graf, Norbert Pritchard-Jones, Kathy International Comparisons of Clinical Demographics and Outcomes in the International Society of Pediatric Oncology Wilms Tumor 2001 Trial and Study |
title | International Comparisons of Clinical Demographics and Outcomes in the International Society of Pediatric Oncology Wilms Tumor 2001 Trial and Study |
title_full | International Comparisons of Clinical Demographics and Outcomes in the International Society of Pediatric Oncology Wilms Tumor 2001 Trial and Study |
title_fullStr | International Comparisons of Clinical Demographics and Outcomes in the International Society of Pediatric Oncology Wilms Tumor 2001 Trial and Study |
title_full_unstemmed | International Comparisons of Clinical Demographics and Outcomes in the International Society of Pediatric Oncology Wilms Tumor 2001 Trial and Study |
title_short | International Comparisons of Clinical Demographics and Outcomes in the International Society of Pediatric Oncology Wilms Tumor 2001 Trial and Study |
title_sort | international comparisons of clinical demographics and outcomes in the international society of pediatric oncology wilms tumor 2001 trial and study |
topic | ORIGINAL REPORTS |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9126524/ https://www.ncbi.nlm.nih.gov/pubmed/35537105 http://dx.doi.org/10.1200/GO.21.00425 |
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