ArticleAnnals of surgery2017
Clinical Outcome and Biological Predictors of Relapse After Nephrectomy Only for Very Low-risk Wilms Tumor: A Report From Children's Oncology Group AREN0532.
Article in Annals of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it, 112 citations in OpenAlex.
- Systematic Review: Prognostic Molecular Biomarkers in Wilms Tumors.JCO precision oncology · 2026Pooled it
- Long-term outcomes and patterns of relapse in patients with bilateral Wilms tumor or bilaterally predisposed unilateral Wilms tumor, a report from the COG AREN0534 study.International journal of cancer · 2024Trial
- Advances and disparities in survival of childhood and adolescent cancers.Journal of the National Cancer Institute · 2026Observational
- Long-term adverse effects of modern Wilms tumour therapies: implications for monitoring.Nature reviews. Urology · 2026Review
- Capturing clinically actionable copy number alterations in Wilms tumor using nanopore sequencing.Research square · 2026Article
- Prognostic factors for long-term survival in Wilms tumor: a retrospective study.BMC pediatrics · 2025Article
- Updated favourable-histology Wilms tumour risk stratification: rationale for future Children's Oncology Group clinical trials.Nature reviews. Urology · 2025Review
- Integrative proteogenomic characterization of Wilms tumor.Nature communications · 2025Article
- Data set for reporting paediatric renal tumours: recommendations from the international collaboration on cancer reporting (ICCR).Histopathology · 2025Review
- Prediction of pediatric Wilms tumor recurrence using interpretable machine learning models: insights from a 20-year real-world study and the prognostic value of Ki-67.American journal of cancer research · 2025Article
- Insights into Personalized Care Strategies for Wilms Tumor: A Narrative Literature Review.Biomedicines · 2024Review
- Loss of heterozygosity for chromosomes 16q in Wilms tumors predicts outcomes: A meta-analysis.World journal of gastrointestinal oncology · 2024Article
- Cancer predisposition signaling in Beckwith-Wiedemann Syndrome drives Wilms tumor development.British journal of cancer · 2024Article
- Children's Oncology Group's 2023 blueprint for research: Surgery.Pediatric blood & cancer · 2024Article
- Hallmark discoveries in the biology of Wilms tumour.Nature reviews. Urology · 2024Review
- Children's Oncology Group's 2023 blueprint for research: Renal tumors.Pediatric blood & cancer · 2023Article
- Late Health Outcomes Among Survivors of Wilms Tumor Diagnosed Over Three Decades: A Report From the Childhood Cancer Survivor Study.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- Biomarkers for patients with Wilms tumor: a review.Frontiers in oncology · 2023Review
- White paper: Oncofertility in pediatric patients with Wilms tumor.International journal of cancer · 2022Article
- Role of Ultrasonography in the Diagnosis of Wilms' Tumour.Children (Basel, Switzerland) · 2022Article
Corrections and comments
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Authors and funding
19 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo determine if observation alone after nephrectomy in very low-risk Wilms tumor (defined as stage I favorable histology Wilms tumors with nephrectomy weight <550g and age at diagnosis <2 years) results in satisfactory event-free survival and overall survival, and to correlate relapse with biomarkers. PATIENTS AND
methodsThe AREN0532 study enrolled patients with very low-risk Wilms tumor confirmed by central review of pathology, diagnostic imaging, and surgical reports. After nephrectomy, patients were followed without adjuvant chemotherapy. Evaluable tumors were analyzed for WT1mutation, 1p and 16q copy loss, 1q copy gain, and 11p15 imprinting. The study was powered to detect a reduction in 4-year EFS from 87% to 75% and overall survival from 95% to 88%.
resultsA total of 116 eligible patients enrolled with a median follow up of 80 months (range: 5-97 months). Twelve patients relapsed. Estimated 4-year event-free survival was 89.7% (95% confidence interval 84.1-95.2%) and overall survival was 100%. First sites of relapse were lung (n = 5), tumor bed (n = 4), and abdomen (n = 2), with one metachronous tumor in the contralateral kidney (n = 1) at a median time of 4.3 months for those who relapsed (range 2.3-44 months). The presence of intralobar (P = 0.46) or perilobar rests (P = 1.0) were not associated with relapse (P = 0.16). 1q gain, 1p and 16q loss, and WT1 mutation status were not associated with relapse. 11p15 methylation status was associated relapse (20% relapse with loss of heterozygosity, 25% with loss of imprinting, and 3.3% relapse with retention of the normal imprinting (P = 0.011)).
conclusionsMost patients meeting very low-risk criteria can be safely managed by nephrectomy alone with resultant reduced exposure to chemotherapy. Expansion of an observation alone strategy for low-risk Wilms tumor incorporating both clinical features and biomarkers should be considered.
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