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Comparative Study
. 2018 Sep:101:38-46.
doi: 10.1016/j.ejca.2018.06.012. Epub 2018 Jul 17.

Survival and mortality rates of Wilms tumour in Southern and Eastern European countries: Socioeconomic differentials compared with the United States of America

Dimitrios Doganis  1 , Paraskevi Panagopoulou  2 , Athanasios Tragiannidis  3 , Theodoros Vichos  2 , Maria Moschovi  4 , Sofia Polychronopoulou  5 , Efthimia Rigatou  5 , Eugenia Papakonstantinou  6 , Eftichia Stiakaki  7 , Helen Dana  8 , Panagiota Bouka  2 , Luis Antunes  9 , Joana Bastos  10 , Daniela Coza  11 , Anna Demetriou  12 , Domenic Agius  13 , Sultan Eser  14 , Anton Ryzhov  15 , Mario Sekerija  16 , Maciej Trojanowski  17 , Tina Zagar  18 , Anna Zborovskaya  19 , Snezana Zivkovic Perisic  20 , Katerina Strantzia  21 , Nick Dessypris  2 , Theodora Psaltopoulou  2 , Eleni Th Petridou  22
Affiliations
Comparative Study

Survival and mortality rates of Wilms tumour in Southern and Eastern European countries: Socioeconomic differentials compared with the United States of America

Dimitrios Doganis et al. Eur J Cancer. 2018 Sep.

Abstract

Background: Despite recent therapeutic advancements, Wilms tumour (WT) presents remarkable survival variations. We explored mortality and survival patterns for children (0-14 years) with WT in 12 Southern and Eastern European (SEE) countries in comparison with the United States of America (USA).

Methods: A total of 3966 WT cases (0-14 years) were registered by a network of SEE childhood cancer registries (N:1723) during available registration periods circa 1990-2016 and surveillance, epidemiology, and end results program (SEER) (N:2243; 1990-2012); mortality data were provided by the respective national statistical services. Kaplan-Meier curves and Cox proportional hazards models were used to assess the role of age, sex, year of diagnosis, urbanisation and Human Development Index (HDI) on overall survival (OS).

Results: Persisting regional variations shape an overall 78% 5-year OS in the participating SEE countries, lagging behind the USA figure (92%, p=0.001) and also reflected by higher SEE mortality rates. Worth mentioning is the gradually escalating OS in SEE (hazard ratio [HR]5-year increment:0.67, 95% confidence interval [CI]:0.60, 0.75) vs. a non-significant 10% improvement in the SEER data, which had a high starting value. OS differentials [two-fold less favourable among children aged 10-14 years, boys and those living in rural SEE areas (HR:1.37; CI:1.10-1.71) or countries with inferior HDI (2-3-fold)] were minimal in the USA.

Conclusions: Children with WT residing in SEE countries do not equally enjoy the substantial survival gains, especially for those living in rural areas and in lower HDI countries. Noteworthy are steep and sizeable survival gains in SEE along with the newly presented Greek data pointing to achievable survival goals in SEE despite the financial crisis.

Keywords: Healthcare access; Mortality trends; Sociodemographic differentials; Survival; Urbanisation; Wilms tumour.

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