Wilms tumor is the most common childhood renal malignancy and the fourth most common childhood cancer. Many biomarkers have been studied but there has been no comprehensive summary. We systematically reviewed the literature on biomarkers in Wilms Tumor with the objective of quantifying the prognostic implication of the presence of individual tumor markers.
We searched for English language studies from 1980-2015 performed on children with Wilms Tumor under 18 years old with prognostic data. The protocol was conducted as per PRISMA guidelines. Two reviewers abstracted data in duplicate using a standard evaluation form. We performed descriptive statistics, then calculated relative risks and 95% confidence intervals for markers appearing in multiple level 2 or 3 studies.
40 studies were included examining 32 biomarkers in 7381 Wilms patients. Studies had a median of 61 patients with 24 biomarker positive patients per study, and a median follow-up of 68.4 months. Median percent of patients in Stage 1, 2, 3, 4, and 5 were 28.5%, 26.4%, 24.5%, 14.1%, and 1.7%, with 10.2% anaplasia. The strongest negative prognostic association was loss of heterozygosity on 11p15, with a risk of recurrence of 5.00, although loss of heterozygosity on 1p and gain of function on 1q were also strongly linked to increased recurrence (2.93 and 2.86 respectively).
Several tumor markers are associated with an increased risk of recurrence or a decreased risk of overall survival in Wilms Tumor. These data suggest targets for development of diagnostic tests and potential therapies.
The Journal of urology. 2016 May 31 [Epub ahead of print]
Eugene B Cone, Stewart S Dalton, Megan Van Noord, Elizabeth T Tracy, Henry E Rice, Jonathan C Routh
Division of Urologic Surgery, Dept of Surgery, Duke University Medical Center, Durham, NC., University of Florida College of Medicine, Gainesville, FL., Duke University Medical Library, Durham, NC., Division of Pediatric Surgery, Dept of Surgery, Duke University Medical Center, Durham, NC., Division of Pediatric Surgery, Dept of Surgery, Duke University Medical Center, Durham, NC., Division of Urologic Surgery, Dept of Surgery, Duke University Medical Center, Durham, NC. Electronic address: .