Objective: This study aims to determine prognostic factors of WT patient in Adam Malik Hospital, Medan. Material & Methods: at Adam Malik Hospital, Medan. Univariate and multivariate Cox regression analyses were performed to determine independent prognostic factors for WT. The primary endpoint of this study were patients’ overall survival (OS) obtained by performing Kaplan-Meier analysis on significant variables. Results: From the univariate Cox regression analysis, gender was found to be the sole significant factor (HR = 0.218, p = 0.005) with males have a higher hazard ratio. The multivariate Cox regression analysis yielded age of diagnosis (HR = 13.860, p = 0.014) and incomplete tumor removals (HR = 0.056, p = 0.008). Kaplan-Meier analysis were performed on three significant variables mentioned before. Only gender yielded a significant Mantel-Cox log-rank score (p = 0.002) with male patients were found to have better survivability (which median survival 476 days compared to females’ 11 days). The survival of the boys was 45.45% while all of the girls did not survive until the cut-off. Conclusion: Three prognostic factors, including children’s gender, age of diagnosis, and tumor removal status, were confirmed to be prognostic factors for the overall survival of children with WT. Further studies covering broader demographic areas were suggested to confirm significant results.
Wilms tumor, prognostic factors, Indonesia, survival, mortality
Daw NC, Huff V, Anderson PM. Wilms tumour. In: Kliegman RM, Stanton BF, Schor NF, St. Gemme III JW, Behrman RE, eds. Nelson textbook of pediatrics. 20th ed. Philadelphia: Elsevier Saunders; 2016. p. 2465.
Cunningham ME, Klug TD, Nuchtern JG, et al. Global Disparities in Wilms Tumour. J Surg Res. 2020; 247: 34‐51
Friedman AD. Wilms tumour. Pediatr Rev. 2013 Jul; 34(7): 328-30.
Davidoff AM. Wilms’ tumour. Curr Opin Pediatr. 2009 Jun; 21(3): 357-64.
Dome JS, Perlman EJ, Graf N. Risk stratification for Wilms tumour: current approach and future directions. Am Soc Clin Oncol Educ Book. 2014; 215‐23.
Tang F, Zhang H, Lu Z, Wang J, He C, He Z. Prognostic Factors and Nomograms to Predict Overall and Cancer-Specific Survival for Children with Wilms' Tumour. Dis Markers. 2019; 2019: 1092769.
Dome JS, Graf N, Geller JI, et al. Advances in Wilms Tumour Treatment and Biology: Progress Through International Collaboration. J Clin Oncol. 2015; 33(27): 2999‐3007.
Dome JS, Fernandez CV, Mullen EA, et al. Children's Oncology Group's 2013 blueprint for research: renal tumours. Pediatr Blood Cancer. 2013; 60(6): 994‐1000
Pritchard-Jones K, Kelsey A, Vujanic G, et al. Older age is an adverse prognostic factor in stage I, favorable histology Wilms' tumour treated with vincristine monochemotherapy: a study by the United Kingdom Children's Cancer Study Group, Wilm's Tumour Working Group. J Clin Oncol. 2003; 21(17): 3269‐75.
D'Angelo P, Di Cataldo A, Terenziani M, et al. Factors possibly affecting prognosis in children with Wilms' tumour diagnosed before 24 months of age: A report from the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP) Wilms Tumour Working Group. Pediatr Blood Cancer. 2017; 64(12): 10.1002/pbc.26644.
Hartono S. Hubungan faktor-faktor Prognosis dan ketahanan hidup penderita Tumour Wilms di RS Dr. Sardjito tahun 2002-2006 (Doctoral dissertation, Universitas Gadjah Mada).
Israels T, et al. Survival of children with a wilms tumor in Blantyre, Malawi. Pediatric hematology and oncology. 2018; 35(3): 196-202.