Background: Wilms’ tumor (WT), the most common malignant neoplasm of the urinary tract of children [1], accounts for 5.9% of childhood cancers and affects one in every 10,000 children worldwide before the age of 15 years. The care of children with Wilm’s tumor in sub-Saharan Africa is compromised due to resource deficiencies that range from inadequate healthcare budgets to paucity of appropriately trained personnel. Childhood Wilms tumor is surging as an important paediatric problem in developing and sub-Saharan Africa countries. The objective of the study is to establish an understanding on the treatment challenges and outcomes of Wilm’s tumor in South West Ethiopia. Results: Forty-three Wilm’s tumor patients who were admitted from January 2017 to December 2021 were included in the study. The most frequent presentation was painless abdominal swelling in 40 (93%) patients. Fourteen patients (32.6%) were hypertensive at the time of diagnosis and the other 13 (30.2%) were normal. In abdominal examination, 31 (72.1%) patients had abdominal mass not crossing the midline and 12 (27.9%) had mass crossing the midline. After multimodal treatment, 37.5% had improvement, 11.6% came back with relapse. Most patients (41.7%) abandoned treatment and 9.3% of the cohort died in the course of treatment. Conclusion: The outcomes in the treatment of Wilms Tumor have been found to be poor in this review. The main reason for poor outcome has been not receiving adequate chemotherapy after surgery. Doses of chemotherapy received after surgery significantly affected treatment outcomes (p = 0.026).
References
[1]
Ekenze, S.O., Agugua-Obianyo, N.E. and Odetunde, O.A. (2006) The Challenge of Nephroblastoma in a Developing Country. Annals of Oncology, 17, 1598-1600. https://doi.org/10.1093/annonc/mdl167
[2]
Breslow, N., Olshan, A., Beckwith, J.B. and Green, D.M. (1993) Epidemiology of Wilms Tumor. Medical and Pediatric Oncology, 21, 172-181. https://doi.org/10.1093/annonc/mdl167
[3]
Beckwith, J.B. and Palmer, N.F. (1978) Histopathology and Prognosis of Wilms Tumor Results from the First National Wilms’ Tumor Study. Cancer, 41, 1937-1948. https://doi.org/10.1002/1097-0142(197805)41:5<1937::AID-CNCR2820410538>3.0.CO;2-U
[4]
Pritchard-Jones, K. (2002) Controversies and Advances in the Management of Wilms’ Tumor. Archives of Disease in Childhood, 87, 241-244. https://doi.org/10.1136/adc.87.3.241
[5]
Hadley, L.G., Rouma, B.S. and Saad-Eldin, Y. (2012) Challenge of Pediatric Oncology in Africa. Seminars in Pediatric Surgery, 136-141, 136-141. https://doi.org/10.1053/j.sempedsurg.2012.01.006
[6]
Yifru, S. and Muluye, D. (2015) Childhood Cancer in Gondar University Hospital, Northwest Ethiopia. BMC Research Notes, 8, Article No. 474. https://doi.org/10.1186/s13104-015-1440-1
[7]
Baez, F., Bellani, F.F., Ocampo, E., Conter, V., Flores, A., Gutierrez, T., Malta, A., Endez, G., Pacheco, C., Palacios, R. and Sala, A. (2002) Treatment of Childhood Wilms’ Tumor without Radiotherapy in Nicaragua. Annals of Oncology, 13, 944-948. https://doi.org/10.1093/annonc/mdf131
[8]
Israëls, T., Molyneux, E.M., Caron, H.N., Jamali, M., Banda, K., Bras, H., Kamiza, S., Borgstein, E. and de Kraker, J. (2009) Preoperative Chemotherapy for Patients with Wilms’ Tumor in Malawi Is Feasible and Efficacious. Pediatric Blood & Cancer, 53, 584-589. https://doi.org/10.1002/pbc.22138
[9]
Hung, I.J., Chang, W.H., Yang, C.P., Jaing, T.H., Liang, D.C., Lin, K.H., Lin, D.T., Hsiao, C.C., Hsieh, Y.L., Chen, J.S. and Chang, T.T. (2004) Epidemiology, Clinical Features and Treatment Outcome of Wilms’ Tumor in Taiwan: A Report from Taiwan Pediatric Oncology Group. Journal of the Formosan Medical Association, 103, 104-111.
[10]
Mpirimbanyi, C., Ndibanje, A.J., Curci, M. and Kanyamuhunga, A. (2021) Surgical Management and Outcomes of Wilms Tumor in Rwanda: A Retrospective Study of Patients Operated on at the University Teaching Hospital of Kigali-Rwanda. Rwanda Medical Journal, 78, 29-34.
[11]
Bezuney, A.D., Groeneveld, A.E. and Heyns, C.F. (2007) Pattern, Clincal Presentation and Management of Wilms’ Tumor in Moshi, Tanzania. African Journal of Urology, 13, 1-7.
[12]
Sidhom, I., Hussien, H., Kotb, M., Anwer, G., Aboul Naga, S., Amin, M., Ebied, E. and Ahmed, H. (2004) Multidisciplinary Approach to Wilms’ Tumor: 10 Years Experience of NCI, Egypt. Journal of Clinical Oncology, 22, 8544. https://doi.org/10.1200/jco.2004.22.90140.8544
Graf, N., Tournade, M.F. and de Kraker, J. (2000) The Role of Preoperative Chemotherapy in the Management of Wilms’ Tumor: The Siop Studies. Urologic Clinics of North America, 27, 443-454. https://doi.org/10.1016/S0094-0143(05)70092-6
[15]
Harif, M., Barsaoui, S., Benchekroun, S., Boccon-Gibod, L., Bouhas, R., Doumbe, P., El Haffaf, Z., Khattab, M., Ladjadj, Y., Mallon, B. and Moreira, C. (2005) Treatment of Childhood Cancer in Africa. Preliminary Results of the French-African Paediatric Oncology Group. Archives de Pediatrie, 12, 851-853. https://doi.org/10.1016/j.arcped.2005.04.050
[16]
Poole, J. (2012) The South African National Wilms Tumour Protocol. SIOP Africa, Cape Town.