Epidemiology, clinical features and treatment outcome of Wilms' tumor in Taiwan: A report from Taiwan Pediatric Oncology Group

Iou Jih Hung, Wan Hui Chang, Chao Ping Yang, Tang Her Jaing, Der Cherng Liang, Kai Hsin Lin, Dong Tsamn Lin, Chih Cheng Hsiao, Yuh Lin Hsieh, Jiann Shiuh Chen, Tai Tsung Chang, Ching Tien Peng, San Ging Shu, Ming Tsan Lin, Bou Wen Chen, Kuo Sin Lin

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17 Citations (Scopus)

Abstract

Background and Purpose: Taiwan Pediatric Oncology Group (TPOG)-W-91 is the first multi-institutional Wilms' tumor study for children in Taiwan. This clinic trial a multidisciplinary approach, bases on and similar to the National Wilms' Tumor Study 4. The study was conducted to evaluate the epidemiological characteristics and analyze the outcome of Wilms' tumor patients treated with this protocol. Methods: Ninety eight children with Wilm's tumor (WT) were analyzed for distributions of age, gender, associated congenital anomalies, tumor sites, histology, tumor weights, and clinical stage. Patients received individualized multimodality treatment based upon the histology of the tumor and clinicopathologic stage. The treatment included surgery, radiotherapy and 2-,3-, and 4-agent active chemotherapeutic agents. Seventy patients were eligible for analysis of treatment outcome. The endpoints were progression-free and overall survival (PFS, OS). Patients were divided into various subgroups according to the chemotherapy regimen used. tumor stage, age at diagnosis, gender, and tumor weight. The prognostic factors were evaluated and the survival rates of various clinical subgroups were compared using log-rank test. Results: The average annual incidence rate of WT was 2.9 per million children under 15 years of age. The M/F ratio was 1.04. The mean age at diagnosis was 3.7 years. All bilateral tumors occurred in females. Congenital anomalies were present in 17.3% patients. Anaplastic histology was found in 6 of 98 cases (6.1%). The stage distribution was: I, 43.2%; II, 19.3%; III, 23.9%, IV, 6.8%. The median follow-up time was 89.1 months (range, 1.8 to 128.1 months). The 5-year PFS rate was 0.7841 (SE, 0.0494; 53 of 70 patients) and the 5-year OS rate was 0.886 (SE, 0.038; 63 of 70 patients). Gender was found to be only significant prognostic variable. Conclusions: This study evaluated the epidemiological characteristics, clinical features, multimodality therapy regimens, and treatment outcome of WT in Taiwan. Data obtained from this study may lead to further improvement in the prognosis of pediatric malignant solid tumor.

Original languageEnglish
Pages (from-to)104-111
Number of pages8
JournalJournal of the Formosan Medical Association
Volume103
Issue number2
Publication statusPublished - 2004 Feb

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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