{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:36:30Z","timestamp":1790987790203,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,7]],"date-time":"2024-01-07T00:00:00Z","timestamp":1704585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Completely necrotic Wilms tumor (CN\u2010WT) following preoperative chemotherapy has been regarded as low\u2010risk WT since the International Society of Paediatric Oncology (SIOP) 93\u201001 study, and patients have been treated with reduced postoperative therapy. The aim of the study was to evaluate whether the omission of adjuvant chemotherapy in patients with localized CN\u2010WT stage I and radiotherapy in stage III was safe.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>The retrospective observational study of outcomes of patients diagnosed with localized CN\u2010WT on central pathology review and treated according to the SIOP 93\u201001 and SIOP\u2010WT\u20102001 protocols (1993\u20132022).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 125 patients with localized CN\u2010WT: 90 with stage I, 10 with stage II, and 25 with stage III. Sixty\u2010two of 125 (49.6%) patients had a discrepant diagnosis and\/or staging between the institutional pathologist and central pathology review. In the group of 90 patients with stage I, postoperative chemotherapy was not given to 41 (46%) patients, whereas 49 patients received postoperative chemotherapy\u2014in the latter group, two patients relapsed, and one of them died. One stage I and one stage II patient developed chemotherapy\u2010induced toxicity and died. Nineteen of 25 patients with stage III received no flank radiotherapy. No stage III patient relapsed or died. The overall 5\u2010year event\u2010free survival (EFS) estimate for the entire cohort (stages I\u2013III) was 96.8% [95% confidence interval, CI: 93.6%\u201399.6%] and the overall survival (OS) was 97.6% [95% CI: 95.0\u2013100%]. The EFS and OS were 97% and 98%, respectively, for stage I, and 100% for stage III.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Omission of postoperative chemotherapy for patients with CN\u2010WT stage I, and radiotherapy for stage III is safe. Rapid central pathology review is required to assign appropriate treatment and avoid treatment\u2010related side effects.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30852","type":"journal-article","created":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T03:59:26Z","timestamp":1704686366000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Omission of adjuvant chemotherapy in patients with completely necrotic Wilms tumor stage I and radiotherapy in stage III: The 30\u2010year SIOP\u2010RTSG experience"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0726-6939","authenticated-orcid":false,"given":"Gordan M.","family":"Vujani\u0107","sequence":"first","affiliation":[{"name":"Department of Pathology Sidra Medicine  Doha Qatar"},{"name":"Weill Cornell Medicine \u2010 Qatar  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2248-323X","authenticated-orcid":false,"given":"Norbert","family":"Graf","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Saarland University Hospital  Homburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0603-8048","authenticated-orcid":false,"given":"Ellen","family":"D'Hooghe","sequence":"additional","affiliation":[{"name":"Department of Pathology Oslo University Hospital Rikshospitalet  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2384-9475","authenticated-orcid":false,"given":"Kathy","family":"Pritchard\u2010Jones","sequence":"additional","affiliation":[{"name":"UCL Great Ormond Street Hospital Institute of Child Health  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3237-2549","authenticated-orcid":false,"given":"Christophe","family":"Bergeron","sequence":"additional","affiliation":[{"name":"Institut d'Hematologie et d'Oncologie P\u00e9diatrique Centre L\u00e9on B\u00e9rard  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4626-8702","authenticated-orcid":false,"given":"Harm van","family":"Tinteren","sequence":"additional","affiliation":[{"name":"Princess Maxima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1967-8343","authenticated-orcid":false,"given":"Rhoikos","family":"Furtw\u00e4ngler","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Saarland University Hospital  Homburg Germany"},{"name":"Division of Pediatric Hematology and Oncology Department of Pediatrics Inselspital University Hospital  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the International Society of Paediatric Oncology Renal Tumour Study Group (SIOP\u2010RTSG)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.08.1749"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24214"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2009.064600"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-911X(200003)34:3<183::AID-MPO4>3.0.CO;2-O"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-911X(199602)26:2<145::AID-MPO15>3.0.CO;2-H"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.1276"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41585-018-0100-3"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17139-0"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)62395-3"},{"key":"e_1_2_10_11_1","unstructured":"R Core Team.R: a language and environment for statistical computing.R Foundation for Statistical Computing;2018. 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