Volume 29, Issue 3 (Iran South Med J 2026)
Iran South Med J 2026, 29(3): 152-164 |
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Alghasi A, Salehi Kahyeh R, Taffakh S, Farhadi kia A, Khazami A, Mafakher L, et al . Clinical Characteristics, Recurrence Patterns, and Survival of Children with Wilms Tumor: A Single-Center Retrospective Cohort Study in Ahvaz, 2017–2024. Iran South Med J 2026; 29 (3) :152-164
URL: http://ismj.bpums.ac.ir/article-1-2593-en.html
URL: http://ismj.bpums.ac.ir/article-1-2593-en.html
Arash Alghasi1 
, Roya Salehi Kahyeh *2 , Soroor Taffakh1 , Arta Farhadi kia3 , Adeleh Khazami4 , Ladan Mafakher1 , Akram Ahangarpour5 , Saeed Bitarf1 , Atefeh Rezaei1
, Roya Salehi Kahyeh *2 , Soroor Taffakh1 , Arta Farhadi kia3 , Adeleh Khazami4 , Ladan Mafakher1 , Akram Ahangarpour5 , Saeed Bitarf1 , Atefeh Rezaei1
1- Thalassemia & Hemoglobinopathy Research center, Health research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2- Thalassemia & Hemoglobinopathy Research center, Health research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran ,Salehikahish-r@ajums.ac.ir
3- Medical Point Hospital, Izmir, Turkey
4- Clinical Research Development Center, Baghaei 2 Hospital Ahvaz, Ahvaz Jundishapur of Medical Sciences, Ahvaz, Iran
5- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2- Thalassemia & Hemoglobinopathy Research center, Health research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran ,
3- Medical Point Hospital, Izmir, Turkey
4- Clinical Research Development Center, Baghaei 2 Hospital Ahvaz, Ahvaz Jundishapur of Medical Sciences, Ahvaz, Iran
5- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Abstract: (255 Views)
Background: Wilms tumor is the most common renal malignancy in children. Despite therapeutic advances, information on its clinical features, survival, and recurrence pattern in Iran, especially in the southern region, remains limited. This study investigated the epidemiological features and factors affecting survival and recurrence in patients with Wilms tumor in Baqaei 2 Hospital in Ahvaz, Iran.
Materials and Methods: This retrospective descriptive-analytical cohort study was conducted on medical records of 50 patients under 18 years of age with a definitive pathological diagnosis of Wilms tumor who were hospitalized and followed up in Baqaei 2 Hospital, Ahvaz, from 2017 to 2024. Demographic data, clinical symptoms, diagnostic and therapeutic methods, disease stage, survival, and recurrence were examined. Survival analysis was performed using the Kaplan–Meier method and Cox regression model.
Results: Of the 50 patients, 28 were female (56%) and 22 were male (44%), with a mean age of 4.8 ± 1.2 years. The most common clinical presentation was a painless abdominal mass (52%; 95% CI: 38.2–65.8). Based on Kaplan-Meier analysis, the 5-year overall survival rate was estimated to be 94% (95% CI: 87.2–100). The 5-year survival rate in stages I and II was 96.1% (95% CI: 91.5–100), whereas in stage IV, it was 71.4% (95% CI: 58.6–84.2). In univariate Cox regression analysis, advanced disease stage was significantly associated with reduced overall survival; HR = 3.21 (95% CI: 1.42–7.26; P = 0.004). Recurrence occurred in six patients (12%), which was descriptively more common in advanced stages; however, due to the limited number of events, an independent inferential analysis was not performed to examine factors associated with recurrence.
Conclusion:. Disease stage at diagnosis was the most important factor associated with overall survival in this cohort. Although recurrence was descriptively more frequent in advanced-stage disease, the limited number of recurrence events precluded a definitive inference regarding an independent association between disease stage and recurrence risk.
Materials and Methods: This retrospective descriptive-analytical cohort study was conducted on medical records of 50 patients under 18 years of age with a definitive pathological diagnosis of Wilms tumor who were hospitalized and followed up in Baqaei 2 Hospital, Ahvaz, from 2017 to 2024. Demographic data, clinical symptoms, diagnostic and therapeutic methods, disease stage, survival, and recurrence were examined. Survival analysis was performed using the Kaplan–Meier method and Cox regression model.
Results: Of the 50 patients, 28 were female (56%) and 22 were male (44%), with a mean age of 4.8 ± 1.2 years. The most common clinical presentation was a painless abdominal mass (52%; 95% CI: 38.2–65.8). Based on Kaplan-Meier analysis, the 5-year overall survival rate was estimated to be 94% (95% CI: 87.2–100). The 5-year survival rate in stages I and II was 96.1% (95% CI: 91.5–100), whereas in stage IV, it was 71.4% (95% CI: 58.6–84.2). In univariate Cox regression analysis, advanced disease stage was significantly associated with reduced overall survival; HR = 3.21 (95% CI: 1.42–7.26; P = 0.004). Recurrence occurred in six patients (12%), which was descriptively more common in advanced stages; however, due to the limited number of events, an independent inferential analysis was not performed to examine factors associated with recurrence.
Conclusion:. Disease stage at diagnosis was the most important factor associated with overall survival in this cohort. Although recurrence was descriptively more frequent in advanced-stage disease, the limited number of recurrence events precluded a definitive inference regarding an independent association between disease stage and recurrence risk.
Original: Original |
Subject:
Blood and cancer
Received: 2025/11/23 | Accepted: 2026/07/20 | Published: 2026/08/23
Received: 2025/11/23 | Accepted: 2026/07/20 | Published: 2026/08/23
References
1. Alomari AI, Tham JC. Denys–Drash syndrome (DDS): Question. Pediatr Nephrol 2006; 21(9): 1237-1240. [DOI]
2. Weksberg R, Teshima I, Williams BRG, et al. Molecular characterization of cytogenetic alterations associated with the Beckwith–Wiedemann syndrome phenotype refines the localization and suggests the gene for BWS is imprinted. Hum Mol Genet 1993; 2(5): 549–556. [DOI]
3. AkhaviRad SMB, Davati A, Jalali Nadoushan MR, et al. A 15-year Clinicopathologic Evaluation Of Wilms’ Tumor In Referrals Of Children Hospital. Iran J Pathol 2006; 1(3): 113-116. [Article]
4. Bardeesy N, Falkoff D, Petruzzi MJ, et al. Anaplastic Wilms’ tumour, a subtype displaying poor prognosis, harbours p53 gene mutations. Nat Genet 1994; 7(1): 91–97. [DOI]
5. Trehan A, Chowdhary SK, Marwaha RK. Wilms tumor: Five year tumor free survival on a modified SI-OP protocol from an Indian university hospital. J Pediatr Hematol Oncol 2012; 34(1): 57–62. [DOI]
6. Rezamand A, Shams AS, Rafeey M, et al. Clinical features and outcome of patients with Wilms tumor hospitalized from 2003 to 2009. Med J Tabriz Uni Med Sciences Health Services 2014; 36(5): 22-27. (Persian) [Article]
7. Khoeini Pourfar H, Esfahani H, Sabzei MK, et al. Study of the 2 year survival rate of children with Wilms tumor in Besat Hospital of Hamadan. Hormozgan medical journal 2014; 18(5): 379-383. [Article]
8. Illade L, Hernández Marqués C, Cormenzana M, et al. Wilms’ tumour: A review of 15 years’ recent experience. An Pediatr (Engl Ed) 2018; 88(3): 140–149. [DOI]
9. Seminara C, Planells MC, Pogonza RE, et al. Wilms tumor: 15 years of experience at a children’s hospital in Córdoba, Argentina. Arch Argent Pediatr 2019; 117(4): 263–270. [DOI]
10. Dome JS, Perlman EJ, Graf N. Risk stratification for Wilms tumor: Current approach and future directions. Am Soc Clin Oncol Educ Book 2014; 34: 215-223. [DOI]
11. Williams RD, Al Saadi R, Natrajan R, et al. Molecular profiling reveals frequent gain of MYCN and anaplasia specific loss of 4q and 14q in Wilms tumor. Genes Chromosomes Cancer 2011; 50(12): 982–995. [DOI]
12. Cunningham ME, Klug TD, Nuchtern JG, et al. Global disparities in Wilms tumor. J Surg Res 2020; 247: 34–51. [DOI]
13. Ssenyonga N, Lopez Cortes A, Al Saadi R, et al. Survival for children diagnosed with Wilms tumour (2012–2022) registered in the UK and Ireland Improving Population Outcomes for Renal Tumours of Childhood (IMPORT) study. Pediatr Blood Cancer 2026; 73(3): e70061. [DOI]
14. Rossoff J, Tse WT, Duerst RE, et al. High dose chemotherapy and autologous hematopoietic stem cell rescue for treatment of relapsed and refractory Wilms tumor: Re evaluating outcomes. Pediatr Hematol Oncol 2018; 35(5-6): 316–321. [DOI]
15. Spreafico F, Pritchard Jones K, Malogolowkin MH, et al. Treatment of relapsed Wilms tumors: Lessons learned. Expert Rev Anticancer Ther 2009; 9(12): 1807–1815. [DOI]
16. Nelson MV, van den Heuvel Eibrink MM, Graf N, et al. New approaches to risk stratification for Wilms tumor. Curr Opin Pediatr 2021; 33(1): 40–48. [DOI]
17. Wu W, Wu Y, Xu W, et al. Teratoid Wilms tumor and classical Wilms tumor: A retrospective 10 year single center study and literature review. Front Surg 2022; 8: 781060. [DOI]
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