PMID- 2540289
OWN - NLM
STAT- MEDLINE
DCOM- 19890605
LR  - 20170210
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 7
IP  - 5
DP  - 1989 May
TI  - Prognostic factors for children with recurrent Wilms' tumor: results from the 
      Second and Third National Wilms' Tumor Study.
PG  - 638-47
AB  - The characteristics of 367 stage I-IV National Wilms' Tumor Study (NWTS) children 
      who relapsed after initial treatment for unilateral disease in the second and 
      third NWTS trials (NWTS-2 and -3) were analyzed to identify features predictive 
      of survival. Although modifications in initial therapy resulted in a lower rate 
      of first relapse in these two studies compared with NWTS-1, all previously 
      identified prognostic factors after relapse remained statistically significant 
      predictors of survival. Tumor histology, length of initial remission, initial 
      therapy with two v three drugs, and site of relapse each were independently 
      predictive of postrelapse survival. The 3-year postrelapse survival for all 367 
      patients was 30% +/- 3%; however, subgroups classified by these prognostic 
      factors were identified that had 3-year postrelapse survival rates of greater 
      than 40%. These subgroups included patients who had tumors of favorable histology 
      (FH) that recurred (1) only in the lungs, (2) in the abdomen when radiotherapy 
      (RT) was not initially given, or (3) that were originally stage I, (4) that were 
      originally treated with only two drugs, or (5) that recurred 12 months or more 
      after diagnosis. These results were achieved with the use of standard treatments, 
      ie, surgery, RT, and chemotherapy using dactinomycin (AMD), vincristine (VCR), 
      and Adriamycin [( ADR] doxorubicin; Adria Laboratories, Columbus, OH). It is 
      suggested that patients in these groups might be managed with aggressive use of 
      conventional therapies until newer chemotherapeutic agents and drug combinations 
      are shown to be more effective. Patients with adverse prognostic features at 
      relapse have a poor survival expectancy with standard measures. Salvage attempts 
      for these patients are better based on experimental approaches.
FAU - Grundy, P
AU  - Grundy P
AD  - Ludwig Institute for Cancer Research, Montreal Branch, Canada.
FAU - Breslow, N
AU  - Breslow N
FAU - Green, D M
AU  - Green DM
FAU - Sharples, K
AU  - Sharples K
FAU - Evans, A
AU  - Evans A
FAU - D'Angio, G J
AU  - D'Angio GJ
LA  - eng
GR  - CA-11722/CA/NCI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Follow-Up Studies
MH  - Humans
MH  - Kidney Neoplasms/*pathology/therapy
MH  - Neoplasm Recurrence, Local/mortality/*pathology/therapy
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Statistics as Topic
MH  - Time Factors
MH  - Wilms Tumor/*pathology/secondary/therapy
EDAT- 1989/05/01 00:00
MHDA- 1989/05/01 00:01
CRDT- 1989/05/01 00:00
PHST- 1989/05/01 00:00 [pubmed]
PHST- 1989/05/01 00:01 [medline]
PHST- 1989/05/01 00:00 [entrez]
AID - 10.1200/JCO.1989.7.5.638 [doi]
PST - ppublish
SO  - J Clin Oncol. 1989 May;7(5):638-47. doi: 10.1200/JCO.1989.7.5.638.