Prognostic impact of lymph node involvement and loss of heterozygosity of 1p or 16q in stage III favorable histology Wilms tumor: A report from Children’s Oncology Group Studies AREN03B2 and AREN0532

Introduction The prognostic impact of positive lymph nodes (LN+) and/or singular loss of heterozygosity (LOH) of 1p or 16q were assessed in children with stage III favorable histology Wilms tumor (FHWT) enrolled on AREN0532 or AREN03B2 alone. Patients and Methods A total of 635 stage III FHWT vincri...

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Published in:Cancer 2024-03, Vol.130 (5), p.792-802
Main Authors: Evageliou, Nicholas, Renfro, Lindsay A., Geller, James, Perlman, Elizabeth, Kalapurakal, John, Paulino, Arnold, Dix, David, Eklund, Meryle J., Murphy, Andrew J., Romao, Rodrigo L. P., Ehrlich, Peter F., Varela, Carly R., Vallance, Kelly, Fernandez, Conrad V., Dome, Jeffrey S., Mullen, Elizabeth A.
Format: Article
Language:English
Subjects:
Child
Dactinomycin
Doxorubicin
Doxorubicin - therapeutic use
Heterozygosity
Histology
Humans
Kidney Neoplasms - drug therapy
Kidney Neoplasms - genetics
Loss of Heterozygosity
lymph node positivity
Lymph nodes
Lymph Nodes - pathology
Patients
Prognosis
Prospective Studies
risk stratification
Sampling
Survival
tumor genetics
Tumors
Vincristine
Wilms tumor
Wilms Tumor - drug therapy
Wilms Tumor - genetics
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Summary:Introduction The prognostic impact of positive lymph nodes (LN+) and/or singular loss of heterozygosity (LOH) of 1p or 16q were assessed in children with stage III favorable histology Wilms tumor (FHWT) enrolled on AREN0532 or AREN03B2 alone. Patients and Methods A total of 635 stage III FHWT vincristine/dactinomycin/doxorubicin (DD4A)–treated patients met inclusion criteria. Event‐free survival (EFS) and overall survival are reported overall and by LN sampling, LN status, LOH 1p, LOH 16q, and a combination of LN status and singular LOH. Patients with unknown or positive combined LOH of 1p and 16q status and AREN03B2‐only patients with unknown outcomes or treatment other than DD4A were excluded. Results EFS did not differ by study, supporting pooling. Lack of LN sampling (hazard ratio [HR], 2.12; p = .0037), LN positivity (HR, 2.78; p = .0002), LOH 1p (HR, 2.18; p = .0067), and LOH 16q (HR, 1.72; p = .042) were associated with worse EFS. Compared with patients with both LN– and LOH–, those with negative nodes but positive LOH 1p or 16q and those with LN+ but LOH– for 1p or 16q had significantly worse EFS (HR, 3.05 and 3.57, respectively). Patients positive for both LN and LOH had the worst EFS (HR, 6.33; overall group factor, p 
ISSN:0008-543X
1097-0142
1097-0142
DOI:10.1002/cncr.35084