title: Treatment and outcome of Wilms' tumour patients: an analysis of all cases registered in the UKW3 trial.
abstract: BACKGROUND
  The randomised findings of the UKW3 trial were that preoperative chemotherapy was associated with a more advantageous stage distribution and reduction in therapy burden versus immediate nephrectomy without compromising outcome in localised Wilms' tumour (WT). We analysed outcome in all WT registered in UKW3.
  
  
  METHODS
  Seven hundred and eighteen WT cases (7% anaplastic) were registered in UKW3. We assigned a treatment stage and conducted survival analysis.
  
  
  RESULTS
  Five-year event-free survival (EFS) and overall survival (OS) were 77.2% [95% confidence interval (CI) 73.9-80.2] and 87.5% (95% CI 84.8-89.7) after median follow-up of 9.5 years and 10.0 years, respectively. Five-year OS in localised non-anaplastic cases was 92.9% (95% CI 90.2-94.9). Anaplasia was associated with adverse outcome compared with non-anaplastic cases: 5-year EFS of 42.0% (95% CI 28.3-55.1) versus 79.8% (95% CI 76.5-82.7) and 5-year OS of 60% (95% CI 45.1-72.0) versus 89.6% (95% CI 87.0-91.7), respectively. Outcomes were similar for non-anaplastic stage I or II but significantly poorer in stage III cases than stage I. Five-year OS after relapse was 54.1% (95% CI 44.5-62.8). Forty-seven percent of non-anaplastic WT received anthracycline; 27% were treated with radiotherapy first line.
  
  
  CONCLUSIONS
  These outcomes provide a baseline for future comparisons of WT treatment approach, burden and patient outcome.
authors.affiliation: Molecular Haematology and Cancer Biology Unit, Institute of Child Health, University College London, London. Electronic address: k.pritchard-jones@ucl.ac.uk.
authors.forename: K
authors.initials: K
authors.lastname: Pritchard-Jones
authors.affiliation: Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham.
authors.forename: V
authors.initials: V
authors.lastname: Moroz
authors.affiliation: Department of Pathology, School of Medicine, Cardiff University, Cardiff.
authors.forename: G
authors.initials: G
authors.lastname: Vujanić
authors.affiliation: Department of Paediatric Surgery, Leeds Teaching Hospitals NHS Trust, Leeds.
authors.forename: M
authors.initials: M
authors.lastname: Powis
authors.affiliation: Department of Paediatric Surgery, Royal Hallamshire Hospital, Sheffield.
authors.forename: J
authors.initials: J
authors.lastname: Walker
authors.affiliation: Section of Paediatric Oncology, Institute of Cancer Research, Sutton.
authors.forename: B
authors.initials: B
authors.lastname: Messahel
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester.
authors.forename: R
authors.initials: R
authors.lastname: Hobson
authors.affiliation: Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Trust, London.
authors.forename: G
authors.initials: G
authors.lastname: Levitt
authors.affiliation: Department of Pathology, Royal Manchester Children's Hospital, Manchester.
authors.forename: A
authors.initials: A
authors.lastname: Kelsey
authors.affiliation: Department of Paediatric Oncology, Oxford Radcliffe Hospitals NHS Trust, Oxford, UK.
authors.forename: C
authors.initials: C
authors.lastname: Mitchell
mesh_terms: D002675:Child, Preschool; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000401:mortality / Q000628:therapy*