The Value of Long-term Follow-up: Lessons from the National Wilms Tumor Study

• Activity Number: 395
• Type: Invited
• Date/Time: Thursday, August 12, 2004 : 8:30 AM to 10:20 AM
• Sponsor: International Indian Statistical Association
• Author(s): Norman E. Breslow*+
• Companies: University of Washington
• Keywords: molecular genetics ; late effects ; childhood cancer ; continuity in data collection

Abstract

Wilms tumor is an embryonal tumor of the kidney that affects approximately one child in every 10,000. During the 20th century, cure rates increased from 10% to 90% as first radiation and then chemotherapy joined surgical removal of the diseased kidney as standard treatment. The National Wilms Tumor Study Group (NWTSG), etablished in 1969, conducted five protocol studies and registered nearly 10,000 patients before terminating patient accrual in 2002. During its last 15 years of operation, the study enrolled 70-80% of the 550 cases estimated to occur annually in North America. Its focus has been the identification of patient subgroups at high or low risk of relapse, and the substitution of combination chemotherapy for radiation therapy, with a primary goal to reduce long-term complications while producing the maximum number of cures. The NWTSG Data and Statistical Center, located in Seattle since the start of the study, has played a major role in this effort. This talk will describe how statistical analyses of the collected data have helped to answer several questions related to the molecular genetics of Wilms tumor.