title: Clinical factors in relapses of Wilms' tumor--results for the Polish Pediatric Solid Tumors Study Group.
abstract: BACKGROUND
  The risk factors responsible for recurrences of Wilms' tumor (nephroblastoma) are still under discussion. The aim of the study was to analyze the relationship between relapses of Wilms' tumor and the patients' clinical history.
  
  
  METHODS
  Clinical data from children registered in the Polish Pediatric Solid Tumors Study Group were analyzed. The clinical stages (CS), pathology variants (high risk: HR, intermediate risk: INT, and low risk: LOW) and chemotherapy regimens were correlated with the outcomes.
  
  
  RESULTS
  Recurrences developed in 34 out of 288 (11.8%) patients with Wilms' tumor treated in accordance with International Society for Pediatric Oncology 2001 (SIOP 2001) protocols. Of these 34 patients, 11 initially had CS I, seven were at CS II, four were at CS III, 11 were at CS IV and one had CS V. There were eight patients with second recurrences; of these, seven were in the INT risk group and one in the high histological risk group. There was no correlation between age (p=0.256) or gender (p=0.538) and the risk of tumor recurrence. In the study group, seven out of 10 patients with local recurrences are alive; as are 13 out of 22 patients with distant recurrences (p=0.703). Those who died due to disease progression comprised six out of 26 patients with a first recurrence (four HR, two INT), and seven out of eight with a second recurrence (one HR, six INT).
  
  
  CONCLUSIONS
  The prognosis after relapse in initially metastatic patients did not differ from that in patients who had primarily localized disease. The pathology variants probably had more significance.
authors.affiliation: Department and Clinic of Pediatric Oncology, Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Niedzielska
authors.affiliation: Department of Pediatric Surgery, Marciniak Hospital, Wrocław, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Bronowicki
authors.affiliation: Department and Clinic of Pediatric Oncology, Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Pietras
authors.affiliation: Department and Clinic of Pediatric Surgery and Urology, Wroclaw Medical University, Poland.
authors.forename: Krystyna
authors.initials: K
authors.lastname: Sawicz-Birkowska
authors.affiliation: Department and Clinic of Pediatric Oncology, Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Trybucka
authors.affiliation: Department of Pediatric Surgery, Marciniak Hospital, Wrocław, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Rąpała
authors.affiliation: Department of Pediatric Hematology and Oncology, Chorzow Pediatrics and Oncology Center, Poland.
authors.forename: Irena
authors.initials: I
authors.lastname: Karpińska-Derda
authors.affiliation: Department of Pediatrics, Hematology and Oncology, Nicolaus Copernicus University, Bydgoszcz, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kurylak
authors.affiliation: Department of Pediatric Oncology, Hematology and Transplantology, Medical University of Poznań, Poland.
authors.forename: Patrycja
authors.initials: P
authors.lastname: Marciniak-Stępak
authors.affiliation: Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Panasiuk
authors.affiliation: Department of Pediatric Oncology and Hematology, Medical University of Lublin, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Nurzyńska-Flak
authors.affiliation: Department of Oncology and Hematology, Pomeranian Medical University in Szczecin, Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Peregud-Pogorzelski
authors.affiliation: Department of Pediatric Hematology and Oncology, Children's University Hospital, Kraków, Poland.
authors.forename: Danuta
authors.initials: D
authors.lastname: Pietrys
authors.affiliation: Department of Pediatric Hematology and Oncology, Medical University of Silesia, Zabrze, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Rurańska
authors.affiliation: Department of Pediatric Oncology, Hematology and Chemotherapy, Medical University of Silesia, Katowice, Poland.
authors.forename: Grażyna
authors.initials: G
authors.lastname: Sobol
authors.affiliation: Clinic of Pediatrics, Hematology, Oncology and Endocrinology, Medical University of Gdańsk, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Stefanowicz
authors.affiliation: Clinic of Pediatric Surgery, Polish-American Institute of Pediatrics, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Sabina
authors.initials: S
authors.lastname: Szymik-Kantorowicz
authors.affiliation: Clinic of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Zubowska
authors.affiliation: Department of Emergency Medicine, Wroclaw Medical University, Poland; Department of Pediatric Surgery, Marciniak Hospital, Wrocław, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Godziński
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011044:Poland; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary