Outcome of Children with Renal Tumor Treated With the JWiTS-1 Protocol

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  • 日本ウィルムス腫瘍スタディグループ-1(JWiTS-1)登録症例の追跡調査報告

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Abstract

Purpose: In 1996, the Japan Wilms Tumor Study (JWiTS) Group was founded in order to elucidate the efficacy and safety of the regimen established by the National Wilms Tumor Study (NWTS) Group in the USA. This report reviews the results of JWiTS-1. Methods: From 1996 to 2005, 307 patients with malignant renal tumors were enrolled in the JWiTS-1 study. Central pathological diagnosis and follow-up data were available in 210 cases. The protocol regimens were similar to the NWTS-5 regimens. Results: The 5-year overall survival rate (OS) was 91.1% for nephroblastoma (n=155), 72.9% for clear cell sarcoma of the kidney (CCSK; n=15) and 22.2% for rhabdoid tumor of the kidney (RTK; n=18). In the nephroblastoma patients, 5-year OS was 90.5% for stage I (n =54), 92.2% for stage II (n=43), 90.9% for stage III (n=11), 86.7% for stage IV (n=15) and 78.7% for stage V (n=12). Twenty-five out of 155 patients with nephroblastoma relapsed, whereas 16 of them re-entered complete remission due to salvage treatment. Conclusions: The outcome of patients treated with the JWiTS-1 protocol was comparable with the outcome of patients treated with other protocols used for multicenter studies in USA and Europe. While the OS of patients with nephroblastoma and CCSK was fairly good, OS of patients with RTK was notsatisfactory. New treatment strategies are needed for patients with RTK.

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