Tumor Biology Influences the Prognosis of Nephroblastoma Patients With Primary Pulmonary Metastases

• DOI: 10.1097/sla.0b013e318222015e
• Publication Date: 2011-06-11T06:57:00Z
• Authors: Steven W. Warmann; Rhoikos Furtwängler; Gunnar Blumenstock; Sorin Armeanu; Nasenien Nourkami; Ivo Leuschner; Jens P. Schenk; Norbert Graf; Jörg Fuchs
• Keywords: Metastasectomy; Anaplasia; Primary tumor

Objective: To analyze the outcome of Wilms' tumor patients with primary lung metastases. Summary background data: Radiotherapy and/or surgery are used for local control pulmonary A widely accepted treatment standardization is still lacking. Methods: Data 210 and metastases from collaborative multicenter trials SIOP 93-01/GPOH 2001/GPOH German Society Pediatric Oncology Hematology were reviewed. Analyses included patient data, characteristics, treatment, possible prognostic factors. Results: Five-year overall survival (OS) was 83.3% 5-year event free (EFS) 72.3% all children. Survival significantly poorer in children high risk histology (OS 44.4%) compared to low 100.0%) intermediate 89.2%, P < 0.001). Within group, tumors blastemal subtype 56.5%) associated a better than those presenting diffuse anaplasia 22.2%, = 0.02). Further, markers lacking response chemotherapy (P 0.011), persistence after 0.007), vitality 0.01). Conclusions: The prognosis mainly depends on biology excellent adequate treatment. Pulmonary metastasectomy indicated if complete remission can be achieved avoid irradiation. In future standardized approach nonresponding (metastasectomy, irradiation, or both) will have prospectively evaluated regarding outcome, acute toxicity, late effects.