Evaluation of needle biopsy as a potential risk factor for local recurrence of Wilms tumour in the SIOP WT 2001 trial

Sabine Irtan, Harm Van Tinteren, Norbert Graf, Marry M. van den Heuvel-Eibrink, Hugo Heij, Christophe Bergeron, Beatriz de Camargo, Tomas Acha, Filippo Spreafico, Gordan Vujanic, Mark Powis, Bruce Okoye, Jim Wilde, Jan Godzinski, Kathy Pritchard-Jones

Research output: Contribution to journalArticle

Abstract

Rationale: The impact of biopsying Wilms tumour (WT)at diagnosis on assigning the tumour stage and recommended treatment remains controversial. To address this important question, we analysed the potential association of all types of biopsy with local recurrence in patients treated in the SIOP WT 2001 trial, where needle biopsy was permitted without ‘upstaging’ the tumour to stage III. Only open biopsy required treatment as stage III. Methods: Among 2971 patients with unilateral WT (stages I-IV), 420 relapsed (139 local). Risk factors for recurrence were analysed by Cox proportional hazard methods. Results: Biopsy was performed in 969 of 2971 (33%)patients (64% cutting needle, 30% fine needle aspiration [FNA]and 6% open biopsy). Biopsied patients were older, with larger tumours and a greater proportion with high-risk histology. In multivariate analysis that included all factors associated with local recurrence in univariate analysis, only high-risk histology (hazard ratio [HR]= 2.32; 95% confidence interval [CI]: 1.58–3.42, p=<0.0001), age≥2 years (HR = 2.24; 95% CI: 1.22–4.09, p = 0.01)and preoperative tumour volume (HR = 1.07 per 100 ml; 95% CI: 1.02–1.12, p = 0.01)were significant. The HR for the association of local recurrence and event-free and overall survival with biopsy was not significant (HR = 1.4; 95% CI: 0.9–2.17, p = 0.13; HR = 1.1; 95% CI: 0.85–1.42, p = 0.46 and HR = 1.13; 95% CI: 0.79–1.62, p = 0.51, respectively). These results were not materially different whether FNA or open biopsy were included in the biopsy group or not. Conclusions: This post hoc analysis provides some reassurance that needle biopsy is not an independent adverse factor for either local recurrence or survival after adjustment for all relevant risk factors. Needle biopsy should not be an automatic criterion to ‘upstage’ WT.

Original languageEnglish
Pages (from-to)13-20
Number of pages8
JournalEuropean Journal of Cancer
Volume116
DOIs
Publication statusPublished - Jul 2019

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Wilms Tumor
Needle Biopsy
Biopsy
Recurrence
Confidence Intervals
Fine Needle Biopsy
Histology
Neoplasms
Tumor Burden
Disease-Free Survival
Needles
Multivariate Analysis
Survival
Therapeutics

Keywords

  • Biopsy
  • Local relapse
  • SIOP WT 2001
  • Wilms tumour

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Irtan, S., Van Tinteren, H., Graf, N., van den Heuvel-Eibrink, M. M., Heij, H., Bergeron, C., ... Pritchard-Jones, K. (2019). Evaluation of needle biopsy as a potential risk factor for local recurrence of Wilms tumour in the SIOP WT 2001 trial. European Journal of Cancer, 116, 13-20. https://doi.org/10.1016/j.ejca.2019.04.027

Evaluation of needle biopsy as a potential risk factor for local recurrence of Wilms tumour in the SIOP WT 2001 trial. / Irtan, Sabine; Van Tinteren, Harm; Graf, Norbert; van den Heuvel-Eibrink, Marry M.; Heij, Hugo; Bergeron, Christophe; de Camargo, Beatriz; Acha, Tomas; Spreafico, Filippo; Vujanic, Gordan; Powis, Mark; Okoye, Bruce; Wilde, Jim; Godzinski, Jan; Pritchard-Jones, Kathy.

In: European Journal of Cancer, Vol. 116, 07.2019, p. 13-20.

Research output: Contribution to journalArticle

Irtan, S, Van Tinteren, H, Graf, N, van den Heuvel-Eibrink, MM, Heij, H, Bergeron, C, de Camargo, B, Acha, T, Spreafico, F, Vujanic, G, Powis, M, Okoye, B, Wilde, J, Godzinski, J & Pritchard-Jones, K 2019, 'Evaluation of needle biopsy as a potential risk factor for local recurrence of Wilms tumour in the SIOP WT 2001 trial', European Journal of Cancer, vol. 116, pp. 13-20. https://doi.org/10.1016/j.ejca.2019.04.027
Irtan, Sabine ; Van Tinteren, Harm ; Graf, Norbert ; van den Heuvel-Eibrink, Marry M. ; Heij, Hugo ; Bergeron, Christophe ; de Camargo, Beatriz ; Acha, Tomas ; Spreafico, Filippo ; Vujanic, Gordan ; Powis, Mark ; Okoye, Bruce ; Wilde, Jim ; Godzinski, Jan ; Pritchard-Jones, Kathy. / Evaluation of needle biopsy as a potential risk factor for local recurrence of Wilms tumour in the SIOP WT 2001 trial. In: European Journal of Cancer. 2019 ; Vol. 116. pp. 13-20.
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title = "Evaluation of needle biopsy as a potential risk factor for local recurrence of Wilms tumour in the SIOP WT 2001 trial",
abstract = "Rationale: The impact of biopsying Wilms tumour (WT)at diagnosis on assigning the tumour stage and recommended treatment remains controversial. To address this important question, we analysed the potential association of all types of biopsy with local recurrence in patients treated in the SIOP WT 2001 trial, where needle biopsy was permitted without ‘upstaging’ the tumour to stage III. Only open biopsy required treatment as stage III. Methods: Among 2971 patients with unilateral WT (stages I-IV), 420 relapsed (139 local). Risk factors for recurrence were analysed by Cox proportional hazard methods. Results: Biopsy was performed in 969 of 2971 (33{\%})patients (64{\%} cutting needle, 30{\%} fine needle aspiration [FNA]and 6{\%} open biopsy). Biopsied patients were older, with larger tumours and a greater proportion with high-risk histology. In multivariate analysis that included all factors associated with local recurrence in univariate analysis, only high-risk histology (hazard ratio [HR]= 2.32; 95{\%} confidence interval [CI]: 1.58–3.42, p=<0.0001), age≥2 years (HR = 2.24; 95{\%} CI: 1.22–4.09, p = 0.01)and preoperative tumour volume (HR = 1.07 per 100 ml; 95{\%} CI: 1.02–1.12, p = 0.01)were significant. The HR for the association of local recurrence and event-free and overall survival with biopsy was not significant (HR = 1.4; 95{\%} CI: 0.9–2.17, p = 0.13; HR = 1.1; 95{\%} CI: 0.85–1.42, p = 0.46 and HR = 1.13; 95{\%} CI: 0.79–1.62, p = 0.51, respectively). These results were not materially different whether FNA or open biopsy were included in the biopsy group or not. Conclusions: This post hoc analysis provides some reassurance that needle biopsy is not an independent adverse factor for either local recurrence or survival after adjustment for all relevant risk factors. Needle biopsy should not be an automatic criterion to ‘upstage’ WT.",
keywords = "Biopsy, Local relapse, SIOP WT 2001, Wilms tumour",
author = "Sabine Irtan and {Van Tinteren}, Harm and Norbert Graf and {van den Heuvel-Eibrink}, {Marry M.} and Hugo Heij and Christophe Bergeron and {de Camargo}, Beatriz and Tomas Acha and Filippo Spreafico and Gordan Vujanic and Mark Powis and Bruce Okoye and Jim Wilde and Jan Godzinski and Kathy Pritchard-Jones",
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T1 - Evaluation of needle biopsy as a potential risk factor for local recurrence of Wilms tumour in the SIOP WT 2001 trial

AU - Irtan, Sabine

AU - Van Tinteren, Harm

AU - Graf, Norbert

AU - van den Heuvel-Eibrink, Marry M.

AU - Heij, Hugo

AU - Bergeron, Christophe

AU - de Camargo, Beatriz

AU - Acha, Tomas

AU - Spreafico, Filippo

AU - Vujanic, Gordan

AU - Powis, Mark

AU - Okoye, Bruce

AU - Wilde, Jim

AU - Godzinski, Jan

AU - Pritchard-Jones, Kathy

PY - 2019/7

Y1 - 2019/7

N2 - Rationale: The impact of biopsying Wilms tumour (WT)at diagnosis on assigning the tumour stage and recommended treatment remains controversial. To address this important question, we analysed the potential association of all types of biopsy with local recurrence in patients treated in the SIOP WT 2001 trial, where needle biopsy was permitted without ‘upstaging’ the tumour to stage III. Only open biopsy required treatment as stage III. Methods: Among 2971 patients with unilateral WT (stages I-IV), 420 relapsed (139 local). Risk factors for recurrence were analysed by Cox proportional hazard methods. Results: Biopsy was performed in 969 of 2971 (33%)patients (64% cutting needle, 30% fine needle aspiration [FNA]and 6% open biopsy). Biopsied patients were older, with larger tumours and a greater proportion with high-risk histology. In multivariate analysis that included all factors associated with local recurrence in univariate analysis, only high-risk histology (hazard ratio [HR]= 2.32; 95% confidence interval [CI]: 1.58–3.42, p=<0.0001), age≥2 years (HR = 2.24; 95% CI: 1.22–4.09, p = 0.01)and preoperative tumour volume (HR = 1.07 per 100 ml; 95% CI: 1.02–1.12, p = 0.01)were significant. The HR for the association of local recurrence and event-free and overall survival with biopsy was not significant (HR = 1.4; 95% CI: 0.9–2.17, p = 0.13; HR = 1.1; 95% CI: 0.85–1.42, p = 0.46 and HR = 1.13; 95% CI: 0.79–1.62, p = 0.51, respectively). These results were not materially different whether FNA or open biopsy were included in the biopsy group or not. Conclusions: This post hoc analysis provides some reassurance that needle biopsy is not an independent adverse factor for either local recurrence or survival after adjustment for all relevant risk factors. Needle biopsy should not be an automatic criterion to ‘upstage’ WT.

AB - Rationale: The impact of biopsying Wilms tumour (WT)at diagnosis on assigning the tumour stage and recommended treatment remains controversial. To address this important question, we analysed the potential association of all types of biopsy with local recurrence in patients treated in the SIOP WT 2001 trial, where needle biopsy was permitted without ‘upstaging’ the tumour to stage III. Only open biopsy required treatment as stage III. Methods: Among 2971 patients with unilateral WT (stages I-IV), 420 relapsed (139 local). Risk factors for recurrence were analysed by Cox proportional hazard methods. Results: Biopsy was performed in 969 of 2971 (33%)patients (64% cutting needle, 30% fine needle aspiration [FNA]and 6% open biopsy). Biopsied patients were older, with larger tumours and a greater proportion with high-risk histology. In multivariate analysis that included all factors associated with local recurrence in univariate analysis, only high-risk histology (hazard ratio [HR]= 2.32; 95% confidence interval [CI]: 1.58–3.42, p=<0.0001), age≥2 years (HR = 2.24; 95% CI: 1.22–4.09, p = 0.01)and preoperative tumour volume (HR = 1.07 per 100 ml; 95% CI: 1.02–1.12, p = 0.01)were significant. The HR for the association of local recurrence and event-free and overall survival with biopsy was not significant (HR = 1.4; 95% CI: 0.9–2.17, p = 0.13; HR = 1.1; 95% CI: 0.85–1.42, p = 0.46 and HR = 1.13; 95% CI: 0.79–1.62, p = 0.51, respectively). These results were not materially different whether FNA or open biopsy were included in the biopsy group or not. Conclusions: This post hoc analysis provides some reassurance that needle biopsy is not an independent adverse factor for either local recurrence or survival after adjustment for all relevant risk factors. Needle biopsy should not be an automatic criterion to ‘upstage’ WT.

KW - Biopsy

KW - Local relapse

KW - SIOP WT 2001

KW - Wilms tumour

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