Extent of Disease

This is one of the most important prognostic factors. The 3-year failure-free survival (FFS) rates based on the IRS-IV experience are summarized in Table 20-9. Children with localized, completely resected disease do better than those with widespread or disseminated disease. Patients with gross residual disease after surgery (group III) have a statistically significantly lower 3-year FFS of 73% compared with 83% and 86% FFS for groups I and II, respectively. Five-year survival for patients with no residual tumor following surgery (clinical group I) is 83%.

Table 20-9. Failure-Free Survival (%) of Children at 3 Years by Stage and Group on IRS-IV
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