{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T06:14:40Z","timestamp":1792304080372,"version":"4.4.0"},"reference-count":56,"publisher":"Harborside Press, LLC","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>Refinements in surgery, radiation therapy, and chemotherapy since the mid-20th century have resulted in a survival rate exceeding 90% for patients with Wilms tumor (WT). Although this figure is remarkable, a significant proportion of patients continue to have event-free survival (EFS) estimates of &lt;75%, and nearly 25% of survivors experience severe chronic medical conditions. The first-generation Children\u2019s Oncology Group (COG) renal tumor trials (AREN \u20180\u2019), which opened to enrollment in 2006, focused on augmenting treatment regimens for WT subgroups with predicted EFS &lt;75% to 80%, including those with the adverse prognostic marker of combined loss of heterozygosity (LOH) at chromosomes 1p\/16q, pulmonary metastasis with incomplete lung nodule response after 6 weeks of chemotherapy, bilateral disease, and anaplastic histology. Conversely, therapy was reduced for patient subgroups with good outcomes and potential for long-term toxicity, such as those with lung metastasis with complete lung nodule response after 6 weeks of chemotherapy. This article summarizes the key findings of the first-generation COG renal tumor studies and their implications for clinical practice.<\/jats:p>","DOI":"10.6004\/jnccn.2021.7070","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T16:01:54Z","timestamp":1629475314000},"page":"978-985","source":"Crossref","is-referenced-by-count":52,"title":["Impact of the First Generation of Children\u2019s Oncology Group Clinical Trials on Clinical Practice for Wilms Tumor"],"prefix":"10.6004","volume":"19","author":[{"given":"Jeffrey S.","family":"Dome","sequence":"first","affiliation":[{"name":"1Division of Oncology, Center for Cancer and Blood Disorders, Children\u2019s National Hospital and the Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Mullen","sequence":"additional","affiliation":[{"name":"2Dana-Farber\/Boston Children\u2019s Cancer and Blood Disorders Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Dix","sequence":"additional","affiliation":[{"name":"3Pediatric Hematology\/Oncology, British Columbia Children\u2019s Hospital, Vancouver, British Columbia, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Gratias","sequence":"additional","affiliation":[{"name":"4eviCore healthcare, Bluffton, South Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter F.","family":"Ehrlich","sequence":"additional","affiliation":[{"name":"5Department of Pediatric Surgery, University of Michigan, CS Mott Children\u2019s Hospital, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najat C.","family":"Daw","sequence":"additional","affiliation":[{"name":"6Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James I.","family":"Geller","sequence":"additional","affiliation":[{"name":"7Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murali","family":"Chintagumpala","sequence":"additional","affiliation":[{"name":"8Texas Children\u2019s Hospital and Baylor College of Medicine, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geetika","family":"Khanna","sequence":"additional","affiliation":[{"name":"9Department of Radiology, Children\u2019s Healthcare of Atlanta, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Kalapurakal","sequence":"additional","affiliation":[{"name":"10Department of Radiation Oncology, Northwestern University School of Medicine, Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay A.","family":"Renfro","sequence":"additional","affiliation":[{"name":"11Children\u2019s Oncology Group and Division of Biostatistics, University of Southern California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth J.","family":"Perlman","sequence":"additional","affiliation":[{"name":"12Department of Pathology, Northwestern University Feinberg School of Medicine, and the Robert H. 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