Bacteria in neoplastic diseases: A brief note on Wilms tumor

Table 2 Salient findings of recent studies that analyzed a considerable number of patients with Wilms tumor for prognostic characteristics

Authors and brief study outline	Statistical significance of the results	Study outcomes
The study by Neuzil et al in 2020[47], tried to characterize health differences among Tennessee (United States) children treated for renal cancers that included Wilms tumor, renal cell carcinoma, and sarcoma	In TCR, for both race groups (black and white), Wilms tumor represented 80% of recorded malignancies. However, in the subgroup analysis of Wilms tumor cases, there was an over-representation of black children (n = 33, 26%) in relation to the state census for this specific race (16.8%). Compared to other renal malignancies, Wilms tumor exhibited the youngest median age at presentation (36 months/IQR: 12.0-48.0). Regarding overall survival, there was no significant difference between black and white patients with Wilms tumor	Wilms tumor remained the most common cancer of the kidney, and renal cell carcinoma was the least common. When combining all renal malignancies, specifically renal cell carcinoma and sarcoma, black children in the state of Tennessee presented with more advanced disease and experienced worse survival
The authors used the TCR (between 2004 and 2015) for patients aged 18 years or younger diagnosed with any form of renal malignancies (n = 160; Wilms tumor cases - 129, i.e., 81%). To further investigate treatment and outcomes, they conducted a retrospective cohort study of pediatric renal cancer patients from their Vanderbilt University Registry (ICR, n = 121; Wilms tumor cases - 100, i.e., 83%)	With reference to Wilms tumor, univariate logistic regression analysis for predicting mortality from pediatric renal malignancies showed a significant difference in case of renal cell carcinoma (OR = 5.75, 95%CI: 1.25-26.5, P value: 0.025) in TCR and (OR = 45.00, 95%CI: 3.77-536.92, P value: 0.003) in ICR, as well as for sarcoma (OR = 11.5, 95%CI: 4.00-33.07, P value < 0.001) in TCR. However, in multivariate analysis, only sarcoma showed a statistical significance (OR = 17.86, 95%CI: 4.68-68.2, P value < 0.001) in TCR	The survival disparities appeared to be reduced when treated at a comprehensive pediatric cancer center, which could alleviate the inequalities. Among both TCR and ICR, metastasis at diagnosis was independently predictive of worse prognosis
	Black patients were 26% of all patients in TCR (in ICR - 21%), presented more frequently with metastasis than white patients (37% vs 16%, P value: 0.021), and demonstrated worse overall survival (73% vs 89%, P value: 0.018). In ICR, similar survival among race groups (92% vs 93%, P value: 0.868) was recorded	The study highlighted the disparities in health outcomes due to socio-economic factors among pediatric renal cancer patients in the state of Tennessee
The study by Ekuk et al[48] in 2023 determined the one-year overall survival of Wilms tumor cases and their predictors among children diagnosed in the Pediatric Oncology and Surgical Units of MRRH, western Uganda	The one-year overall survival rate was found to be 59.3% (95%CI: 40.7-73.3)	Overall survival of Wilms tumor at MRRH was found to be 59.3%, and prognostic factors documented were unfavorable histology and tumor size greater than 15 cm
In this study, the treatment charts and files of children diagnosed and managed for Wilms tumor (n = 41) were retrospectively reviewed for the period from January 2017 to January 2021. The clinical details of children with histologically confirmed diagnoses were examined for demographic information, clinical and histological characteristics, and treatment modalities	Tumor size greater than 15 cm was identified as a significant predictor of poor survival, with a P value of 0.021. Tumor size above 15 cm was found to increase the risk of death from Wilms tumor by 6 times (95%CI: 1.32-34.95)
	Unfavorable Wilms tumor type (anaplasia) was another significant predictor of poor survival, with a P value of 0.012	The study highlighted the importance of tumor size and histology in predicting the survival outcomes for children with Wilms tumor
	Unfavorable histology type was found to increase the risk of death from Wilms tumor by 5.1 times (95%CI: 1.77-92.50)

TCR: Tennessee Cancer Registry; ICR: Institutional Cancer Registry; IQR: Interquartile range; OR: Odds ratio; CI: Confidence interval; MRRH: Mbarara Regional Referral Hospital.