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Biological Prognostic Factors in Wilms Tumors

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Renal Tumors of Childhood

Part of the book series: Pediatric Oncology ((PEDIATRICO))

Abstract

The outcome is now good for most patients with Wilms tumor of the kidney. Over and above the gains in survival, the ability to progressively regulate the amount of chemotherapy and radiation so that groups of patients are receiving dosing adequate to achieve cure, but not more, has been made possible by the use of prognostic factors. We often now think of prognostic factors as molecular or biological findings, but factors used to predict outcome in patients with Wilms tumor – to thereby stratify therapy – include histology (favorable vs anaplastic), stage (using criteria such as lymph node involvement, local or intravascular tumor extension, and presence of metastatic disease), age at diagnosis, response to therapy, and now molecular or genetic changes (loss of heterozygosity (LOH) for chromosomes 1p and 16q).

Prognostic factors are determined retrospectively and must always be validated in a second population of patients. Furthermore, prognostic factors are dependent on the treatment used in the population in which they are identified. Thus, as therapy changes from study to study, so too can prognostic factors change, so they must be constantly reassessed. Examples of these principles are discussed and information on current prognostic factors being utilized is presented.

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Authors and Affiliations

  1. Department of Developmental Biology and Cancer, Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK

    Kathy Pritchard-Jones

  2. Post-doctoral research scientist, Institute of Child Health, Cancer Section, University College London (UCL), 30 Guilford Street, London, WC1N 1EH, UK

    Mariana Maschietto

  3. Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada

    Paul Grundy

Authors
  1. Kathy Pritchard-Jones
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  2. Mariana Maschietto
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  3. Paul Grundy
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Correspondence to Kathy Pritchard-Jones .

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Editors and Affiliations

  1. Department of Developmental Biology and Cancer, Institute of Child Health, University College London, London, United Kingdom

    Kathy Pritchard-Jones

  2. Children's National Medical Center Center for Cancer & Blood Disorders, Washington, District of Columbia, USA

    Jeffrey S. Dome

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Pritchard-Jones, K., Maschietto, M., Grundy, P. (2014). Biological Prognostic Factors in Wilms Tumors. In: Pritchard-Jones, K., Dome, J. (eds) Renal Tumors of Childhood. Pediatric Oncology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44003-2_9

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  • DOI: https://doi.org/10.1007/978-3-662-44003-2_9

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