Browse by author
Lookup NU author(s): Dr Juliet Hale
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
Purpose: To determine if patients receiving preoperative chemotherapy with vincristine and actinomycin D for non-metastatic Wilms' tumour have a more advantageous stage distribution and so need less treatment compared to patients who have immediate nephrectomy, without adversely affecting outcome. Methods: Between 1991 and 2001, a total of 205 patients with newly diagnosed non-metastatic renal tumours, of which 186 had Wilms' histologies, were randomly assigned either to immediate surgery or to 6 weeks preoperative chemotherapy and then delayed surgery. Both groups of children received postoperative chemotherapy according to tumour stage and histology determined at the time of nephrectomy Results: There was a significant improvement in the stage distribution for patients with Wilms' histologies receiving delayed surgery compared to those having immediate nephrectomy (stage L 65.2% versus 54.3%; stage 11: 23.9% versus 14.9%; stage 111: 9.8% versus 29.8%, chi(2) test for trend = 7.02, p = 0.008). This improvement resulted in 20% fewer children receiving radiotherapy or doxorubicin yet event-free and overall survivals at 5 years of 79.6% and 89.0%, respectively, were similar in the two groups. Conclusion: Six weeks of preoperative chemotherapy with vincristine and actinomycin D results in a significant shift towards a more advantageous stage distribution and hence reduction in therapy, while maintaining excellent event free and overall survival in children with non-metastatic Wilms' tumour. Around 20% of survivors were therefore spared the late-effects of doxorubicin or radiotherapy. Our results suggest that all children with non-metastatic Wilms' tumour should receive chemotherapy prior to tumour resection. (c) 2006 Elsevier Ltd. All rights reserved.
Author(s): Mitchell C, Pritchard-Jones K, Shannon R, Hutton C, Stevens S, Machin D, Imeson J, Kelsey A, Vujanic GM, Gornall P, Walker J, Taylor R, Sartori P, Hale J, Levitt G, Messahel B, Middleton H, Grundy R, Pritchard J, United Kingdom Cancer Study Group
Publication type: Article
Publication status: Published
Journal: European Journal of Cancer
Year: 2006
Volume: 42
Issue: 15
Pages: 2554-2562
ISSN (print): 0959-8049
ISSN (electronic): 1879-0852
Publisher: Pergamon
URL: http://dx.doi.org/10.1016/j.ejca.2006.05.026
DOI: 10.1016/j.ejca.2006.05.026
Altmetrics provided by Altmetric