Wilms' Tumor in Children : A Single Institution 10-Year Experience

Abstract

Objective: To evaluate the disease characteristics and treatment outcome of children with wilms’ tumor at King Hussein Medical Center over a period of 10 years. Methods: We conducted a retrospective review of the medical files of children ( < 14 years ) with wilms’ tumor who were managed at King Hussein Medical Center -Jordan in the interval between June, 2000 until June, 2010 . Patients’ and disease characteristics, treatment modalities and outcome were analyzed. Staging and histopathological classification were preformed according to the system of the National Wilms Tumor Study Group (NWTSG). Descriptive analysis using frequencies was used to describe the study variables. Results: A total of 61 patients (54.1% female) with wilms’ tumor with a median age of 40 months were identified. Their ages ranged between seven months and 7.8 years. The stage frequencies of our cases were : stage I ( 27.9 % ) , stage II (34.4 % ) , stage III ( 16.4 % ) , stage IV ( 11.5 %) and stage V ( 9.8 %) . The 3- year relapse-free survival rate was 100%, 81%, 70%, 57.1% and 83.3% for stages I , II , III , IV and V, respectively. Favorable histology accounted for 86.9 % (53 cases) of our patients . The 3-year relapse-free survival rate was 84.9% for the favorable histology and 62.5% for the anaplastic histology .The 3- year relapse-free survival rate for the entire group was 82%. Conclusion: Combined modality management including surgery , chemotherapy and radiotherapy resulted in satisfactory loco-regional and systemic control and better relapse-free survival in pediatric patients with wilms’ tumor . Stage and histopathologic classification of the disease were important as prognostic factors.