Treatment of Wilms tumor: a report from the Turkish Pediatric Oncology Group (TPOG).
OBJECTIVE
To standardize diagnosis and treatment of childhood Wilms tumor (WT) in Turkey.


METHODS
Between 1998 and 2006, WT patients were registered from 19 centers. Patients <16 years with unilateral WT whose treatment started in first postoperative 3 weeks were included. Treatments were stage I favorable (FH) and unfavorable histology (UH) patients, VCR + Act-D; stage IIA FH, VCR + Act-D; stage IIB FH, VCR + Act-D + radiotherapy (RT); stage III-IV FH, VCR + Act-D + adriamycin (ADR) + RT; stages II-IV UH tumors, VCR + Act-D + ADR + etoposide + RT.


RESULTS
165/254 registered cases were eligible (bilateral, 5.9%) [median age 3.0 years; M/F: 0.99; 50/165 cases < or =2 years]. 9.7% cases had UH tumors. Disease stages were stage I 23.6%; IIA 36.4%; IIB 5.5%; III 22.4%; IV 12.1%. Cases >2 years had significantly more advanced disease. 1/11 cases with recurrent disease died; 2/165 had progressive disease, 2/165 had secondary cancers, and all 4 died. In all cases 4-year OS and EFS were 92.8 and 86.5%, respectively. Both OS and EFS were significantly worse in stage IV.


CONCLUSIONS
Despite problems in patient management and follow-up, treatment results were encouraging in this first national experience with a multicentric study in pediatric oncology. Revisions and modifications are planned to further improve results and minimize short- and long-term side effects.
Akyüz
Canan
C
Hacettepe University Faculty of Medicine, Dept. of Pediatric Oncology, Ankara, Turkey. cakyuz@hacettepe.edu.tr
Yalçin
Bilgehan
B
Yildiz
Inci
I
Hazar
Volkan
V
Yörük
Asim
A
Tokuç
Gülnur
G
Akici
Ferhan
F
Büyükpamukçu
Nebil
N
Kale
Gülsev
G
Atahan
Lale
L
Büyükünal
Cenk
C
Dervişoğlu
Sergülen
S
Atkovar
Gülyüz Akyil
GA
Melikoğlu
Mustafa
M
Karpuzoğlu
Gülten
G
Olgun
Nur
N
Ayan
Inci
I
Oğuz
Aynur
A
Yariş
Nilgün
N
Dağdemir
Ayhan
A
Darendeliler
Emin
E
Sander
Serdar
S
Kuyumcuoğlu
Uğur
U
Ozşeker
Naciye
N
Corapçioğlu
Funda
F
Tanyeli
Atilla
A
Düzovali
Oznur
O
Aydin
G Burça
GB
Büyükpamukçu
Münevver
M
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007680:Kidney Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D009396:Wilms Tumor / Q000401:mortality / Q000628:therapy*