Patterns of Care and Survival Comparison of Adult and Pediatric Wilms Tumor in the United States: A Study of the National Cancer Database.
Document Type
Article
Publication Date
1-2020
Identifier
DOI: 10.1016/j.urology.2019.10.007
Abstract
Objective: To describe and compare the management of WT and oncologic outcomes by patient age using a large national database.
Methods: The National Cancer Database was queried for patients with WT diagnosis from 2004 to 2013. Patients were grouped by age and compared: pediatric (<16 >years), young adults (16-35 years) and adult (>35 years). Overall survival (OS) was the primary endpoint. Factors associated with OS were determined using multivariate analysis.
Results: The majority of patients were pediatric (n = 2686), followed by young adult (n = 91), and adult (n = 35). Five-year OS was significantly better for children vs young adults or adults (93.1% vs 79.1% vs 78.9%, respectively; P15 years were less likely to undergo lymph node sampling (OR 0.19; P
Conclusion: Adults with WT experience worse 5- and 10-year OS when compared to children with WT. Survival decrements in adults are likely multifactorial including modifiable factors such as inadequate staging due to low rates of lymph node sampling, and underutilization of adjuvant therapies.
Journal Title
Urology
Volume
135
First Page
50
Last Page
56
MeSH Keywords
Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Chemoradiotherapy, Adjuvant; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Kaplan-Meier Estimate; Kidney Neoplasms; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Staging; Nephrectomy; Practice Patterns, Physicians'; Prognosis; Registries; Retrospective Studies; United States; Wilms Tumor; Young Adult
Keywords
Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Chemoradiotherapy, Adjuvant; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Kaplan-Meier Estimate; Kidney Neoplasms; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Staging; Nephrectomy; Practice Patterns, Physicians'; Prognosis; Registries; Retrospective Studies; United States; Wilms Tumor; Young Adult
Recommended Citation
Saltzman AF, Carrasco A Jr, Amini A, Cost NG. Patterns of Care and Survival Comparison of Adult and Pediatric Wilms Tumor in the United States: A Study of the National Cancer Database. Urology. 2020;135:50-56. doi:10.1016/j.urology.2019.10.007
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