Prognostic impact of lymph node involvement and loss of heterozygosity of 1p or 16q in stage III favorable histology Wilms tumor: A report from Children's Oncology Group Studies AREN03B2 and AREN0532

被引:2
|
作者
Evageliou, Nicholas [1 ,20 ]
Renfro, Lindsay A. [2 ,3 ]
Geller, James [4 ]
Perlman, Elizabeth [5 ]
Kalapurakal, John [6 ]
Paulino, Arnold [7 ]
Dix, David [8 ]
Eklund, Meryle J. [9 ]
Murphy, Andrew J. [10 ]
Romao, Rodrigo L. P. [11 ]
Ehrlich, Peter F. [12 ]
Varela, Carly R. [13 ,14 ,15 ]
Vallance, Kelly [16 ]
Fernandez, Conrad V. [17 ,18 ]
Dome, Jeffrey S. [13 ,15 ]
Mullen, Elizabeth A. [19 ]
机构
[1] Childrens Hosp Philadelphia, Div Oncol, Philadelphia, PA USA
[2] Univ Southern Calif, Div Biostat, Monrovia, CA USA
[3] Childrens Oncol Grp, Monrovia, CA USA
[4] Univ Cincinnati, Cincinnati Childrens Hosp Med Ctr, Div Oncol, Cincinnati, OH USA
[5] Northwestern Univ, Ann & Robert H Lurie Childrens Hosp Chicago, Dept Pathol & Lab Med, Chicago, IL USA
[6] Northwestern Univ, Robert H Lurie Canc Ctr, Dept Radiat Oncol, Chicago, IL USA
[7] MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX USA
[8] British Columbia Childrens Hosp, Div Oncol, Vancouver, BC, Canada
[9] Med Univ South Carolina, Dept Radiol, Charleston, SC USA
[10] St Jude Childrens Res Hosp, Dept Surg, Memphis, TN USA
[11] Dalhousie Univ, Dept Surg & Urol, IWK Hlth, Halifax, NS, Canada
[12] Univ Michigan, Dept Surg, Sect Pediat Surg, Ann Arbor, MI USA
[13] Childrens Natl Hosp, Div Oncol, Washington, DC USA
[14] Inova Fairfax Hosp, Div Pediat Hematol & Oncol, Fairfax, VA USA
[15] George Washington Univ, Dept Pediat, Sch Med & Hlth Sci, Washington, DC USA
[16] Cook Childrens Hosp, Div Hematol Oncol, Ft Worth, TX USA
[17] IWK Hlth Ctr, Dept Pediat, Halifax, NS, Canada
[18] Dalhousie Univ, Halifax, NS, Canada
[19] Dana Farber Boston Childrens Canc & Blood Disorder, Boston, MA USA
[20] Childrens Hosp Philadelphia, 1012 Laurel Oak Rd, Voorhees, NJ 08043 USA
基金
美国国家卫生研究院;
关键词
lymph node positivity; risk stratification; tumor genetics; Wilms tumor; SIOP WT 2001; SURVIVAL; DOXORUBICIN;
D O I
10.1002/cncr.35084
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Introduction: The prognostic impact of positive lymph nodes (LN+) and/or singular loss of heterozygosity (LOH) of 1p or 16q were assessed in children with stage III favorable histology Wilms tumor (FHWT) enrolled on AREN0532 or AREN03B2 alone.Patients and methods: A total of 635 stage III FHWT vincristine/dactinomycin/doxorubicin (DD4A)-treated patients met inclusion criteria. Event-free survival (EFS) and overall survival are reported overall and by LN sampling, LN status, LOH 1p, LOH 16q, and a combination of LN status and singular LOH. Patients with unknown or positive combined LOH of 1p and 16q status and AREN03B2-only patients with unknown outcomes or treatment other than DD4A were excluded.Results: EFS did not differ by study, supporting pooling. Lack of LN sampling (hazard ratio [HR], 2.12; p = .0037), LN positivity (HR, 2.78; p = .0002), LOH 1p (HR, 2.18; p = .0067), and LOH 16q (HR, 1.72; p = .042) were associated with worse EFS. Compared with patients with both LN- and LOH-, those with negative nodes but positive LOH 1p or 16q and those with LN+ but LOH- for 1p or 16q had significantly worse EFS (HR, 3.05 and 3.57, respectively). Patients positive for both LN and LOH had the worst EFS (HR, 6.33; overall group factor, p < .0001).Conclusion: Findings confirm LN+ status as an adverse prognostic factor amplified by presence of singular LOH 1p or 16q, supporting study of intensified therapy for patients with LN+ in combination with singular LOH in a prospective clinical trial.
引用
收藏
页码:792 / 802
页数:11
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