Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr;69(4):e29503.
doi: 10.1002/pbc.29503. Epub 2021 Dec 15.

Outcomes of Wilms tumor treatment in western Kenya

Aniek Uittenboogaard  1   2 , Festus Njuguna  3 , Saskia Mostert  1   2 , Sandra Langat  4 , Mirjam E van de Velde  1 , Gilbert Olbara  3 , Terry A Vik  5 , Gertjan J L Kaspers  1   2
Affiliations
Free article

Outcomes of Wilms tumor treatment in western Kenya

Aniek Uittenboogaard et al. Pediatr Blood Cancer. 2022 Apr.
Free article

Abstract

Background/objectives: Wilms tumor (WT) is a curable type of cancer with 5-year survival rates of over 90% in high-income countries, whereas this is less than 50% in low- and middle-income countries. We assessed treatment outcomes of children with WT treated at a large Kenyan teaching and referral hospital.

Design/methods: We conducted a retrospective record review of children diagnosed with WT between 2013 and 2016. Treatment protocol consisted of 6 weeks of preoperative chemotherapy and surgery, and 4-18 weeks of postoperative chemotherapy depending on disease stage. Probability of event-free survival (pEFS) and overall survival (pOS) was assessed using Kaplan-Meier method with Cox regression analysis. Competing events were analyzed with cumulative incidences and Fine-Gray regression analysis.

Results: Of the 92 diagnosed patients, 69% presented with high-stage disease. Two-year observed EFS and OS were, respectively, 43.5% and 67%. Twenty-seven percent of children died, 19% abandoned treatment, and 11% suffered from progressive or relapsed disease. Patients who were diagnosed in 2015-2016 compared to 2013-2014 showed higher pEFS. They less often had progressive or relapsed disease (p = .015) and borderline significant less often abandonment of treatment (p = .09). Twenty-nine children received radiotherapy, and 2-year pEFS in this group was 86%.

Conclusion: Outcome of children with WT improved over the years despite advanced stage at presentation. Survival probabilities of patients receiving comprehensive therapy including radiation are approaching those of patients in high-income countries. Additional improvement could be achieved by ensuring that patients receive all required treatment and working on earlier diagnosis strategies.

Keywords: Wilms tumor; chemotherapy; outcomes research; pediatric oncology; sub-Saharan Africa; surgery.

PubMed Disclaimer

References

REFERENCES

    1. Szychot E, Apps J, Pritchard-Jones K. Wilms' tumor: biology, diagnosis and treatment. Transl Pediatr. 2014;3(1):12-24.
    1. Cunningham ME, Klug TD, Nuchtern JG, et al. Global disparities in Wilms tumor. J Surg Res. 2020;247:34-51.
    1. Hadley LG, Rouma BS, Saad-Eldin Y. Challenge of pediatric oncology in Africa. Semin Pediatr Surg. 2012;21(2):136-141.
    1. Global initiative for childhood cancer. World Health Organization. Accessed April 20, 2021. https://www.who.int/cancer/childhood-cancer/en/
    1. WHO global initiative for childhood cancer. St. Jude Children's Research Hospital. Accessed June 2, 2021. https://www.stjude.org/global/collaborating-to-cure/global-initiative.html