Thesis (M.Sc.) - Cairo University - National Cancer Institute - Department of Pediatric Oncology

Background: Although the overall relapse rate for children with WT has decreased to less than 15%, the overall long-term survival for patients with recurrent disease remains at approximately 50%. A combination of chemotherapy and molecularly targeted therapies will likely be necessary to push the post-relapse survival rate beyond 90%. Methods: There were 130 pediatric cases diagnosed with Wilms{u2019} tumor between the years 2008 and 2015 at the National cancer institute, Cairo university, Egypt. From these cases, 30 had relapsed. We were concerned with collecting information at initial disease phase and at relapse phase. Certain factors were analysed in relevance to survival: these were age, gender, initial tumor stage, initial histology, time to relapse from nephrectomy and from diagnosis, site of relapse and radiotherapy received at relapse. Most studied patients were treated according to the modified COG protocol. Objectives: Our study aimed at estimating the overall survival (OS) and event free survival (EFS) for the relapsed cases and to correlate the survival rates with the different risk factors. Results: The median follow up period was 22.3 months (ranged from 3.6 to 140.7 months). The OS was 30.9% while the EFS was 29.8% at a 5-year follow up period. The median age at diagnosis in our study was 4 years (48 months) with a mean of 4.4 years (52.8 months). Median time from diagnosis to relapse in our study was 14.4 months. A second complete remission was attained in 18/30 patients (60%). The final outcome of the 30 patients; 10 are alive and 19 had died. One patient has travelled to Sudan while in CR. Two factors in our univariate analysis were prognostically significant for survival after relapse

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