Collins observed that Wilms tumor were more likely to recur within given period of time. It it had not then the patient had a good chance of being cured. The same rule has been applied to other pediatric tumors of an “embryonic” nature.
Tumors in the embryonic group in addition to Wilms tumor:
(1) neuroblastoma
(2) rhabdomyosarcoma
(3) medulloblastoma
(4) Ewing’s sarcoma
(5) ependymoma
(6) supratentorial PNET
(7) synovial sarvoma
Parameters:
(1) age of the patient at the time of initial tumor diagnosis in months
Collins risk period in months = CRP =
= (age at initial diagnosis in months) + 9
The person was most likely to relapse within a period defined by the CRP. If the patient had not relapsed within that period then there was a good chance that the child was cured.
Interpretation:
• minimum CRP: 9 (for a patient with tumor present at birth)
• maximum: varies with the age at diagnosis
• Paulino noted that 98% of tumors that relapsed in his series did so within the CRP.
The followup period of a patient can be referenced as a ratio:
followup as multiple of the CRP =
= (months of followup) / (CRP)
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