{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T21:23:08Z","timestamp":1783113788253,"version":"3.54.6"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100022850","name":"Little Princess Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100022850","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011692","name":"Children's Cancer and Leukaemia Group","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011692","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Wilms tumour (WT) has excellent event\u2010free and overall survival (OS). However, small differences exist between countries participating in the same international study. This led us to examine variation in adherence to protocol recommendations as a potential contributing factor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective analysis of risk\u2010stratified chemotherapy and radiotherapy regimens given to children with unilateral WT treated with pre\u2010operative chemotherapy in the SIOPWT2001 (2002\u20132011) and Improving Population Outcomes for Renal Tumours of Childhood (IMPORT) (2012\u20132018) studies in the United Kingdom and Ireland. Pre\u2010 and post\u2010operative treatments were classified as per protocol (PP), deviation (PDEV)\u2014variation for specified clinical reasons, violation (PVIOL)\u2014not treated PP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1256 children with WT were registered by 20 centres. A total of 1052 (84%) had unilateral WT treated with pre\u2010operative chemotherapy. All had centrally reviewed pathology. Case report forms allowing categorisation of the whole treatment pathway were available for 756 (72%) patients. Treatment was classified as PP in 452 (60%), PDEV in 175 (23%) and PVIOL in 129 (17%). Stage III\/IV tumours had higher proportion PVIOL (21% and 35%, respectively) compared to Stage I\/II tumours (8%\u201310%). Two\u2010thirds of patients were treated in \u2018high\u2010volume\u2019 centres (\u22655 new WTs\/year). Protocol adherence rates were similar between high\u2010 and low\u2010volume centres. Protocol adherence category had no impact on event\u2010free or OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Protocol guidelines are followed closely for lower stage tumours, but there is greater variation in advanced disease. Centre size showed no association with survival, emphasising the effectiveness of using a national treatment protocol, supported by central pathology review.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70324","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T12:19:42Z","timestamp":1776255582000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adherence to Protocol Recommendations for Children With Wilms Tumour in Two Consecutive Studies in the United Kingdom and Ireland\u2014Does Variation Matter?"],"prefix":"10.1002","volume":"73","author":[{"given":"Suzanne","family":"Tugnait","sequence":"first","affiliation":[{"name":"Developmental Biology &amp; Cancer Research &amp; Teaching Department, UCL Great Ormond Street Institute of Child Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Al\u2010Saadi","sequence":"additional","affiliation":[{"name":"Directorate of Medicines, Therapies and Test, Great Ormond Street Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Lopez\u2010Cortes","sequence":"additional","affiliation":[{"name":"Developmental Biology &amp; Cancer Research &amp; Teaching Department, UCL Great Ormond Street Institute of Child Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Dzhuma","sequence":"additional","affiliation":[{"name":"Developmental Biology &amp; Cancer Research &amp; Teaching Department, UCL Great Ormond Street Institute of Child Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Oostveen","sequence":"additional","affiliation":[{"name":"Developmental Biology &amp; Cancer Research &amp; Teaching Department, UCL Great Ormond Street Institute of Child Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Brok","sequence":"additional","affiliation":[{"name":"Rigshospitalet, Copenhagen University Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Irtan","sequence":"additional","affiliation":[{"name":"Department of Visceral Paediatric and Neonatal Surgery Sorbonne Universite, H\u00f4pital Armand Trousseau\u2014APHP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Weeks","sequence":"additional","affiliation":[{"name":"Lung and Heart Institute Imperial College  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Bate","sequence":"additional","affiliation":[{"name":"Paediatric Oncology University Hospital Southampton NHS Foundation Trust  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Baker","sequence":"additional","affiliation":[{"name":"Cancer Research UK Clinical Trials Unit University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Williams","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Section of Genetics and Genomics, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Powis","sequence":"additional","affiliation":[{"name":"Paediatric Surgery Leeds Teaching Hospital NHS Trust  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Saunders","sequence":"additional","affiliation":[{"name":"Northern Care Alliance NHS Foundation Trust in Manchester  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Olsen","sequence":"additional","affiliation":[{"name":"Paediatric Oncology Great Ormond Street Hospital for Children NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Watson","sequence":"additional","affiliation":[{"name":"Paediatric Oncology Great Ormond Street Hospital for Children NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Shelmerdine","sequence":"additional","affiliation":[{"name":"Paediatric Oncology Great Ormond Street Hospital for Children NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Vaidya","sequence":"additional","affiliation":[{"name":"Children and Young People's Unit Royal Marsden Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Howell","sequence":"additional","affiliation":[{"name":"Paediatric Oncology Alder Hey Children's Hospital NHS Foundation Trust  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Duncan","sequence":"additional","affiliation":[{"name":"Paediatric Oncology Great Ormond Street Hospital for Children NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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