Continuing barriers to care of Wilms tumor in a low-income country

Pediatric Blood & Cancer
S O EkenzeOkechukwu O Okafor

Abstract

This study evaluates the outcome of Wilms tumor (WT) following introduction of multidisciplinary team management and patient treatment stratification by tumor histology in two referral centers in southeastern Nigeria. We analyzed histologically confirmed WT cases managed from January 2008 to June 2017. There were 45 patients, peak age incidence of 2 to 5 years who presented after mean symptom duration of 4.9 months (range, 1-12 months), with mean tumor weight of 1040 g (range, 350-4200 g). Overall, 14 (31.1%) had unfavorable histology of WT. A total of 22 (48.9%) patients received preoperative chemotherapy, 43 (95.6%) received postoperative chemotherapy based on stage of disease and histopathology, but none received adequate radiotherapy. Of these, 19 (44.2%) patients complied with chemotherapy regimen, 15 (33.3%) were lost to follow-up and 12 (26.7%) cases relapsed. With 30 cases available for evaluation and mean follow-up duration of 23 months (range, 6-80 months), the overall 5-year survival is 53.3% (16 cases). Survival in children who complied with postoperative chemotherapy was 73.7%, and abandonment-sensitive survival was 35.6%. Persisting challenges were late presentation, poor compliance to treatment, and lack of radio...Continue Reading

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Citations

Sep 11, 2020·Pediatric Blood & Cancer·Sebastian O EkenzeIkenna I Nnabugwu
Jul 25, 2020·Pediatric Hematology and Oncology·Begül Yağcı-Küpeli, Ayşe Özkan

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