XXXX in Ontario, 1977-1987: population-based results.

@entity1 @entity12817 @entity5 @entity693 @entity204 @entity2946
A retrospective review was carried out to study @entity1 , not more than 16 years old, with a confirmed diagnosis of @entity2946 , who were residents of the Province of Ontario at the time of diagnosis between 1977 and 1987 inclusive. The provincial @entity5 registry provided the population database. One hundred and eight @entity1 with @entity2946 were identified of whom 72 (67%) were initially treated at University of Toronto Centres and 36 (33%) at other Health Science Centres, hospitals, and @entity5 ( @entity5 ) in Ontario. The hospital/ @entity5 Centre records were reviewed. The 5-year relapse-free survival (RFS) for all @entity1 treated in Ontario was 58% (SE = 5%). Those treated in Toronto had a 5-year RFS of 65% (SE = 6%) compared to 44% (SE = 8%) for those treated in other RCCs in the province (P = 0.02). Relapse-free survival for the RCCs ranged from 25 to 60%, with a trend for improved survival with increasing centre size. Univariate analysis of determinants of relapse-free survival for all 108 @entity1 showed the following variables to be significant: T-stage (Tx + T1 + T2 vs. @entity12817 + T3B) P = 0.0004, M-stage (M0 + Mx vs. M1-4) P = 0.0006, extent of resection (total vs. less than total) P = 0.002, radiotherapy (craniospinal irradiation and posterior fossa boost vs. other) P = 0.02, and treatment centre (Toronto centres vs. @entity5 ) P = 0.02. Cases treated at centres outside metropolitan Toronto had a nearly two-fold (relative risk = 1.93; 95% confidence interval = 1.07, 3.47) greater risk of recurrence or @entity204 than those seen in Toronto. However, in multivariate analysis this difference was not quite significant (P = 0.07) after controlling for stage (T and M), extent of resection, @entity693 , and gender. These data suggest that @entity1 with @entity2946 should be referred for treatment to large centres with major pediatric neurosurgical and oncology resources.
