Management of Wilm's tumor at the Lagos University Teaching Hospital (a 10-year retrospective study)

Abstract

Background: Wilms' tumor (WT), also known as nephroblastoma, is the most frequently diagnosed renal tumor in children, accounting for 6% of all childhood tumors. It is relatively more common in blacks and majority of cases are diagnosed within the first 3 years of life. Aim: The study aimed to review the prevalence, pattern of presentation, and management outcome of WT at the Lagos University Teaching Hospital (LUTH). Methodology: This is a retrospective study of patients diagnosed with WT at LUTH between January 2004 and December 2013. Results: A total of 108 patients were retrieved for this study. Sixty (55.56%) patients were male and 48 (44.44%) were female with a male-to-female ratio of 1.25:1. The age range was from 9 months to 11 years with a mean age of 4 (standard deviation: ±2.37) years. The most common mode of presentation was an abdominal mass, and 66.67% of the patients presented with Stages III–V. Fifty percent of the patients had complete response following treatment (chemotherapy [CHT]) and 33 (30.6%) patients had partial response (i.e., 30% reduction in tumor size). Twenty-one (19.4%) patients had a progression of disease despite the treatment. Eleven (20.37%) had recurrence after 5 years of completing their treatment. Disease-free survival rate at 5-year posttreatment was 31.48%. Conclusion: Most of the patients presented with advanced disease at diagnosis resulting in poor response and survival. Early presentation and diagnosis will improve the results. Combination treatment with surgery and CHT gives the best results.