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. 2024 May;59(5):1009-1014.
doi: 10.1016/j.jpedsurg.2023.12.018. Epub 2023 Dec 16.

Characteristics and Clinical Outcomes of Children With Wilms' Tumour: A 15-year Experience in a Single Centre in Nigeria

Abdulrasheed A Nasir  1 , Nurudeen T Abdur-Raheem  2 , Lukman O Abdur-Rahman  2 , Taibat T Ibiyeye  3 , Tolulope O Sayomi  2 , Olanrewaju T Adedoyin  4 , James O Adeniran  2
Affiliations

Characteristics and Clinical Outcomes of Children With Wilms' Tumour: A 15-year Experience in a Single Centre in Nigeria

Abdulrasheed A Nasir et al. J Pediatr Surg. 2024 May.

Abstract

Background: Wilms' tumor (WT) is the most common paediatric renal tumor and is one of the most treatment-responsive solid tumours. Survival from Wilms tumour (WT) in sub-Saharan Africa remains dismal as a result of late presentation, treatment abandonment and infrastructure deficit. The purpose of this study was to analyze the clinical outcome of children with Wilms tumour managed in a Nigerian referral centre over a 15-year period.

Methods: This is a retrospective study of children with WT (nephroblastoma) who were treated at our institution between January 2006 and December 2020. Clinical characteristics, treatments, and outcomes were analyzed.

Results: Thirty-five patients were identified. The median age at diagnosis was 36 months including 22 (62.9 %) females. Twenty-six (74.3 %) had advanced (stage III & IV) disease. Confirmatory histology was available for 16 patients ((45.7 %) among which 10 (62.5 %) were mixed type. The right kidney was affected in 18 patients (51.4 %), left in 15 (42.9 %) and 2 were not documented. Preoperative chemotherapy was given in 22 (62.9 %) patients and 13 (37.1) patients had primary nephrectomy. Eight (22.9 %) patients died during treatment (from disease or treatment related causes), and one abandoned treatment. A total of 26 patients completed treatment. Out of these, 8 (30.8 %) were lost to follow up, four patients died and 14 (53.8 %) patients survived at a median follow-up period of 18 months. The survival decreased with advancing stages of the disease, p = 0.002.

Conclusions: Majority of children with Wilms tumour in our practice presented with advanced disease. Death during treatment, treatment abandonment and lost to follow up were common.

Level of evidence: Level II.

Type of study: Retrospective Study.

Keywords: Abandonment; Mortality; Nephroblastoma; Preoperative chemotherapy; Primary nephrectomy; Sub-sahara africa; Survival; Wilms tumor; Wilms' tumor.

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Conflict of interest statement

Conflict of interest Authors have no conflict of interest to disclose. The authors alone are responsible for the content and writing of the paper.