Secondary malignant neoplasms after Wilms tumor: an international collaborative study.
Secondary malignant neoplasms after Wilms tumor: an international collaborative study.
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DOI：
10.1002/ijc.25067
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发表时间：
2010-08-01
影响因子：
6.4
通讯作者：
Robison, Leslie L.
中科院分区：
文献类型：
--
作者：
Breslow, Norman E.;Lange, Jane M.;Friedman, Debra L.;Green, Daniel M.;Hawkins, Mike M.;Murphy, Michael F. G.;Neglia, Joseph P.;Olsen, Jorgen H.;Peterson, Susan M.;Stiller, Charles A.;Robison, Leslie L.
为了确定继发性恶性肿瘤(SMN)的风险，在1960-2004年间建立了一个由8,884名北美、2,893名英国和1,574名北欧受试者组成的联合队列，这些受试者在15岁之前被诊断为肾母细胞瘤(WT)。经过169,641人年(PY)至2005年的观察，195名受试者中发现174例实体瘤(不包括基底细胞癌)和28例白血病。WT确诊为SMN 5年或更长时间后，中位生存期为11年；所有白血病患者的中位生存期为10个月。继发性实体瘤的年龄别发病率从15岁时的每千例中约1例增加到40岁时的每千例中约5例。无SMN存活至15岁的受试者在40岁时实体瘤的累积发生率为6.7%。相比之下，白血病风险在WT诊断后的前5年最高。实体瘤和白血病的标化发病率比(SIRS)分别为5.1和5.0。三个地理区域的实体肿瘤结果非常一致；发病率和SIRS差异的统计检验均为阴性。1980年后被诊断为WT的患者的年龄别发病率和实体瘤的SIRS较低，尽管随着诊断年限的增加，这一趋势没有统计学意义。白血病的发病率和SIRS在1990年以后确诊的人群中最高(p趋势=0.003)。这些趋势可能反映了现代西药治疗方案中放射治疗的减少和化疗强度的增加。
A combined cohort of 8,884 North American, 2,893 British and 1,574 Nordic subjects with Wilms tumor (WT) diagnosed before 15 years of age during 1960–2004 was established to determine the risk of secondary malignant neoplasms (SMN). After 169,641 person-years (PY) of observation through 2005, 174 solid tumors (exclusive of basal cell carcinomas) and 28 leukemias were ascertained in 195 subjects. Median survival time following a solid SMN diagnosis 5 years or more from WT was 11 years; it was 10 months for all leukemia. Age-specific incidence of secondary solid tumors increased from approximately 1 case per 1,000 PY at age 15 to 5 cases per 1,000 PY at age 40. The cumulative incidence of solid tumors at age 40 for subjects who survived free of SMNs to age 15 was 6.7%. Leukemia risk, by contrast, was highest during the first 5 years following WT diagnosis. Standardized incidence ratios (SIRs) for solid tumors and leukemias were 5.1 and 5.0, respectively. Results for solid tumors for the 3 geographic areas were remarkably consistent; statistical tests for differences in incidence rates and SIRs were all negative. Age-specific incidence rates and SIRs for solid tumors were lower for patients whose WT was diagnosed after 1980, though the trends with decade of diagnosis were not statistically significant. Incidence rates and SIRs for leukemia were highest among those diagnosed after 1990 (p-trend =0.003). These trends may reflect the decreasing use of radiation therapy and increasing intensity of chemotherapy in modern protocols for treatment of WT.
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影响因子：
45.3
作者：
Green, DM;Breslow, NE;D'Angio, GJ
通讯作者：
D'Angio, GJ
影响因子：
10.3
作者：
Olsen, Jorgen H.;Moller, Torgil;Garwicz, Stanislaw
通讯作者：
Garwicz, Stanislaw
影响因子：
45.3
作者：
BRESLOW, NE;TAKASHIMA, JR;GREEN, DM
通讯作者：
GREEN, DM
影响因子：
6.6
作者：
Cherullo, EE;Ross, JH;Novick, AC
通讯作者：
Novick, AC
影响因子：
3.7
作者：
KAPLAN, EL;MEIER, P
通讯作者：
MEIER, P