Poorer Outcome in Favorable-Histology Wilms Tumor Associated With Chromosome 1q Gain Reported in U.S. Study


Key Points

  • Chromosome 1q gain was associated with poorer event-free survival among all patients with favorable-histology Wilms tumor and across disease stages.
  • Chromosome 1q gain was associated with poorer overall survival among all patients and in stages I and IV disease.

The Children’s Oncology Group found that chromosome 1q gain is associated with poorer event-free and overall survival in patients with favorable-histology Wilms tumor. Gratias et al reported these findings in the Journal of Clinical Oncology.

Study Details

The study involved analysis of unilateral favorable-histology Wilms tumors from 1,114 patients in National Wilms Tumor Study-5 with previously determined information on 1p and 16q microsatellite marker status and that proved informative for 1q gain, 1p loss, and 16q loss using multiplex ligation–dependent probe amplification.

Event-Free and Overall Survival

In the entire cohort, 8-year event-free survival was 86%, including 77% among 317 patients (28%) with tumors with 1q gain vs 90% among those lacking 1q gain (P < .001); 8-year overall survival was 88% vs 96% (P < .001). The presence of 1q gain was associated with poorer event-free survival in stage I (85% vs 95%, P = .0052), stage II (81% vs 87%, P = .0775), stage III (79% vs 89%, P = .01), and stage IV disease (64% vs 91%, P = .001) and with significantly poorer overall survival in stage I (90% vs 98%, P = .0015) and stage IV disease (74% vs 92%, P = .011).

On multivariate analysis, 1q gain was associated with an increased relative risk of relapse of 2.4 (P < .001); 1p loss was associated with an increased risk on univariate but not multivariate analysis.

The investigators concluded: “Gain of 1q is associated with inferior survival in unilateral [favorable-histology Wilms tumors] and may be used to guide risk stratification in future studies.”

The study was supported by grants from the National Institutes of Health.

Elizabeth J. Perlman, MD, of Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University, is the corresponding author of the Journal of Clinical Oncology article.

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