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. 2015 Jul;62(7):1259-64.
doi: 10.1002/pbc.25484. Epub 2015 Mar 25.

Second malignant neoplasms among children, adolescents and young adults with Wilms tumor

Jean S Lee  1 , Benjamin Padilla  2 , Steven G DuBois  1 , Aris Oates  1 , John Boscardin  3 , Robert E Goldsby  1
Affiliations

Second malignant neoplasms among children, adolescents and young adults with Wilms tumor

Jean S Lee et al. Pediatr Blood Cancer. 2015 Jul.

Abstract

Background: The goal of this study was to describe the incidence, characteristics, and outcomes of secondary malignant neoplasms (SMN) in survivors of Wilms tumor.

Procedures: Patients who were 0-20 years of age at time of primary diagnosis with Wilms tumor and reported to the Surveillance, Epidemiology, and End Results [SEER] program between 1973 and 2011 were eligible for inclusion in the cohort. We used competing risks methods to estimate the cumulative incidence of SMNs and assess contributing factors for developing SMN. We estimated standardized incidence ratios (SIR), absolute excess risk and overall survival after SMN using standard methods.

Results: Within the SEER database, 2,851 patients were diagnosed with Wilms tumor as their first malignancy. Of these, 34 patients were reported to have a SMN. Cumulative incidence of for a secondary malignancy was 0.6% (95% confidence interval [95% CI] 0.3-1.0%) at 10 years, 1.6% (95% CI 1.0-2.3%) at 20 years, and 3.8% (95% CI 2.4-5.9%) at 30 years. Median time from primary diagnosis to SMN diagnosis was 12.5 years. SIR for SMN for survivors of Wilms tumor was 3.4 (95% CI 2.2-4.9) with an absolute excess risk of 7.6 per 10,000 persons per year. Exposure to radiation did not significantly increase risk for development of second malignancy. Overall survival for patients with SMN was 64.5% at 5 years.

Conclusion: Survivors of Wilms tumor are at an increased risk of SMN compared to the general population, but the added risk is relatively small compared to other pediatric cancers.

Keywords: Wilms tumor; late effects of cancer treatment; long-term survival; outcomes research; second malignant neoplasms.

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Figures

Figure 1
Figure 1
Cumulative incidence of any second malignant neoplasms among all patients with Wilms tumor
Figure 2
Figure 2
Cumulative incidence of any second malignant neoplasms among patients with Wilms tumor who did and did not receive radiation treatment
Figure 3
Figure 3
Overall survival for patients with Wilms tumor with second malignant neoplasm
See this image and copyright information in PMC

References

    1. Friedman AD. Wilms tumor. Pediatrics in review / American Academy of Pediatrics. 2013;34(7):328–330. discussion 330. - PubMed
    1. Pietras W. Advances and changes in the treatment of children with nephroblastoma. Advances in clinical and experimental medicine : official organ Wroclaw Medical University. 2012;21(6):809–820. - PubMed
    1. Green DM. The evolution of treatment for Wilms tumor. Journal of pediatric surgery. 2013;48(1):14–19. - PubMed
    1. Cotton CA, Peterson S, Norkool PA, Takashima J, Grigoriev Y, Green DM, Breslow NE. Early and late mortality after diagnosis of wilms tumor. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2009;27(8):1304–1309. - PMC - PubMed
    1. Breslow NE, Norkool PA, Olshan A, Evans A, D’Angio GJ. Second malignant neoplasms in survivors of Wilms’ tumor: a report from the National Wilms’ Tumor Study. Journal of the National Cancer Institute. 1988;80(8):592–595. - PubMed

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