Abstract
Background: Wilms tumor (WT) demonstrates epidemiological differences by world region and ethnicity. To enhance understanding of these differences, we retrospectively analyzed clinical trial data sets from the UK and Japan over a 20-year period.
Procedure: We used data from three consecutive clinical trials in the UK and a single study in Japan that enrolled patients diagnosed during 1996-2015, to compare clinical characteristics and outcomes between countries.
Results: During 1996-2015, 1395 patients in the UK and 537 in Japan were included. Japanese patients have a significantly younger median age at diagnosis than those in the UK (28 months vs 39 months). The proportion of patients with stage IV, large tumors, and anaplastic histology appears to be higher in the UK than in Japan (18% vs 11%, 62% vs 49%, 8% vs 3%, respectively). During 2005-2015, 77 hospitals treated WT in Japan compared with only 20 hospitals in the UK. Five-year overall survival of patients with WT was over 90% in both countries, but five-year event-free survival of patients with stage IV was significantly lower in Japan than in the UK (50.0% vs 76.2%, P = 0.001).
Conclusions: Differences in age of onset, tumor size at diagnosis, and histology may reflect differences in the genetic background of patients with WT between countries, but population-based phenotype-genotype data are lacking. The difference in survival probability for stage IV patients may be due to different diagnostic criteria or different treatment strategies. Prospective, international clinical studies including genomic analyses are needed to confirm these findings and improve clinical practice.
| Original language | English |
|---|---|
| Article number | e29143 |
| Number of pages | 12 |
| Journal | Pediatric Blood and Cancer |
| Volume | 68 |
| Issue number | 10 |
| Early online date | 31 May 2021 |
| DOIs | |
| Publication status | Published - Oct 2021 |
Bibliographical note
Funding Information:This study was supported by The Daiwa Anglo‐Japanese Foundation (11990/12790); a Grant‐in‐Aid for Early‐Career Scientists from the Japan Society for the Promotion of Science KAKENHI (JP20K18952; to KN); a Health, Labour and Welfare Sciences Research Grant from the Ministry of Health, Labour and Welfare of Japan (Grant Number H30‐Gantaisaku‐ippan‐009, 20EA1026; to KN). KPJ is funded in part by the National Institute for Health Research (NIHR) Great Ormond Street Hospital Biomedical Research Centre. The UKW3 trial was supported by the Children's Cancer and Leukaemia Group (CCLG) and funded by Cancer Research UK. The SIOP WT 2001 trial was funded by CRUK (grants C1010/A2889 and C1188/A8687) and managed by the Cancer Research UK Clinical Trials Unit, University of Birmingham. The early parts of the IMPORT study were funded by Great Ormond Street Hospital Children's Charity and Cancer Research UK (Grant No. C1188/ A4614). The IMPORT/UMBRELLA study in the UK is funded by the CCLG/Little Princess Trust (grants CCLGA 2019 10 and 2019 27B) and CCLG/Bethany's Wish CCLGA 2017 02). We would like to thank Dr. Julia Mortimer for helping us with the English language.
Publisher Copyright:
© 2021 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC
Keywords
- age at diagnosis
- childhood renal tumor
- Japan
- survival
- UK
- Wilms tumor
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Hematology
- Oncology