Improvement of survival in Wilms Tumor patients at the paediatric oncology unit, KATH

Abstract

BackgroundWilms Tumor (WT) is one of the common and curable cancer types targeted by the World Health Organization (WHO) Global initiative for childhood cancer (GICC). Although, survival in high income countries is good, the same cannot be said of survival in low- and middle-income countries (LMIC) like Ghana. The main aim of this study was to determine the clinical presentation and survival of patients with WT presenting at the Komfo Anokye Teaching Hospital MethodsThis research is a 5-year (2016 - 2020) prospective hospital based cross sectional study. Patient characteristics, tumor characteristics and outcome were described, and survival analysis was done. The survival was compared to a historical cohort (2011- 2013) which was evaluated in 2015 where 18.5% of patients survived. ResultsA total of 51 patients were seen over the 5-year period with a male to female ratio of 1.2:1. The median age of presentation was 3years. Majority of patients (56.5%) presented with a left sided renal mass. A significant proportion presented with Stage III (37.1%) and Stage IV (20.98%) disease. The commonest site of metastasis was the liver with 19.4% of patients presenting with it. Thirty three percent (33%) of the patients died with 8(47%) occurring before initiation of treatment. Mortality was highest amongst patients with advanced disease with a p-value of 0.19. The 3-year event free survival with abandonment as an event in patients seen from 2016 - 2019 was 55.6% (p-0.026). ConclusionPatients with high stage tumors (Stage III and IV) were at a higher risk of death as compared to the patients with lower stage tumors. Early detection and treatment of patients with WT can lead to a favorable outcome.