Meta-analysis of the effect of preoperative chemotherapy on Wilms' tumor.

PURPOSE: To evaluate the effect of preoperative chemotherapy on the event-free survival (EFS) and overall survival (OS) of Wilms' tumor in children, and to provide a basis for further improvement of clinical therapeutic effect and research level.

METHODS: Relevant studies before July 2017 were retrieved from PubMed, EMBASE, Web of Science and other databases, and two evaluators were responsible independently for the studies' selection, data extraction and cross-checking according to the inclusion and exclusion criteria. EFS and OS of patients were assessed using hazard ratio (HR) and 95% confidence interval (CI). All analyses, including publication bias assessment, were performed using Stata 12 software.

RESULTS: 12 studies meeting the criteria, with a total of 1639 patients, were finally enrolled. Meta-analysis showed that the preoperative chemotherapy combined with surgery, compared with surgery alone, could improve the EFS and OS of patients with Wilms' tumor (HR=1.26, 95% CI 1.07, 1.48 and 1.12 (1.03, 1.22, respectively). Both sensitivity analysis and publication bias assessment revealed that the results were reliable with no significant publication bias.

CONCLUSIONS: Compared with surgery alone, preoperative chemotherapy combined with surgery can increase the EFS and OS and improve the prognosis of patients.