SynthesisAsian Pacific journal of cancer prevention : APJCP2025
Wilms Tumor Management: A Systematic Review Comparing SIOP and NWTS/COG Protocols in Diagnosis, Treatment, and Outcome.
Synthesis in Asian Pacific journal of cancer prevention : APJCP, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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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
1 citing paper in PubMed.
- Preoperative neutrophil-to-lymphocyte ratio as an early risk-stratification and prognostic biomarker in Wilms tumor: a retrospective study.Frontiers in oncology · 2026Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWilms tumor is the most common pediatric renal malignancy, with two predominant management approaches creating clinical decision-making challenges. SIOP advocates preoperative chemotherapy to reduce tumor burden, while NWTS/COG prioritizes immediate surgery for histopathological analysis. Evidence-based comparison is essential, particularly in resource-limited settings.
objectiveTo systematically compare preoperative chemotherapy (SIOP) versus upfront nephrectomy (NWTS/COG) protocols in Wilms tumor management by analyzing diagnostic accuracy, treatment efficacy, and surgical outcomes through direct comparative studies.
methodsA PRISMA 2020-guided systematic review was conducted, searching PubMed, ScienceDirect, SpringerLink, and Google Scholar for comparative studies (2015-2024) that directly compared SIOP and NWTS/COG protocols in pediatric Wilms tumor patients. Quality assessment was performed using the ROBINS-I tool.
resultsFour comparative studies encompassing 226 patients from developing countries (India, Pakistan, Iraq, Vietnam) were included. Diagnostic accuracy varied significantly, with SIOP protocols showing misdiagnosis rates of 17.4-21.7% in resource-limited settings, while NWTS protocols achieved 100% accuracy in the single study reporting this outcome. Surgical outcomes were heterogeneously reported: one Indian study found no intraoperative spillage in SIOP patients (0/23) versus 22.2% in NWTS patients (2/9), though this finding cannot be generalized due to single-center limitations. Postoperative complications varied by setting, with one Pakistani study reporting higher rates in SIOP patients (21% vs. 9.5%). Survival outcomes ranged from 80.9-96.7% across protocols and countries, with no consistent pattern favoring either approach.
conclusionNeither protocol demonstrates consistent superiority across all outcomes. Protocol selection should be individualized based on disease stage, diagnostic capabilities, and healthcare infrastructure. The limited number of comparative studies and heterogeneous reporting highlight the need for standardized outcome measures and larger multicenter trials.
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