Outcome Of Wilms Tumors Among Children At Single Center In A Developing Country
DOI:
https://doi.org/10.51985/JBUMDC2018048Keywords:
Renal Tumors, Wilms Tumor, chemotherapy, Societe international D’oncologiepediatrique, National Wilms tumor study boardAbstract
Objective: To determine the outcome of wilms tumors among children in our center and compare the results of treatment
on the basis of management proposed by the National Wilms tumor study board (NWTS) and the Societe international
D’oncologie pediatrique (SIOP)
Patients and methods:- This study includes 49 children who presented to the Aga Khan University Hospital(AKUH) with
wilms tumors from January 1988 to December 2015 (aged 0-16 years). Patients were further divided according to the
treatment strategies they received i.e NWTS and SIOP. Data was analyzed using SPSS 10.
Results:-.A total of 49 patients (57%male and 43% female) were included in the study. Majority of the cases (56%) were
between 1-5 years. The tumors mostly presented on the right side (65%).The diagnostic work up of the patients mainly
involved CT imaging (69%).35% of children in the SIOP group presented with stage 3 diseases whereas in the NWTS
group 42% presented with stage 1 disease. In the SIOP group 4 (14%) patients had disease reoccurrence and 2 (7%) patients
died. In the NWTS group 2(10%) patients had disease reoccurrence and 1 (5%) patient expired. A 5 year survival rate of
both groups was calculated to be more than 80%. Mean follow up in SIOP group was 119 months and In NWTS group
was 114 months.
Conclusions:- Wilms tumors are curable in the majority of the patients even with limited resource as in our country. The
NWTS and SIOP treatment approaches are almost equally effective at our center however adherence to a single treatment
is mandatory for effective treatments.
References
Störkel S, Eble JN, Adlakha K, Amin M, Blute ML, Bostwick
DG, Darson M, Delahunt B, Iczkowski K. Classification of
renal cell carcinoma. Cancer. 1997;80(5):987-9.
Parkin DM, Stiller CA, Draper GJ, Bieber CA. The
international incidence of childhood cancer. International
Journal of Cancer. 1988;42(4):511-20.
Ward E, DeSantis C, Robbins A, Kohler B, Jemal A (2014)
Childhood and adolescent cancer statistics,. CA Cancer J Clin
;64:83–103.
Dome JS, Graf N, Geller JI, Fernandez CV, Mullen EA,
Spreafico F et al (2015) Advances in Wilms tumor treatment
and biology: progress through international collaboration. J
Clin Oncol. 2015;33:2999–3007.
D’Angio GJ. SIOP and the management of Wilms’ tumour.
JClin Oncol 1983;1:595–6.
The National Wilms’ Tumour Study Committee. Wilms’
tumour: status report, 1990. J Clin Oncol 1991;9:877–87.
Lemerle J, Voute PA, Tournade MF, et al. Effectiveness of
preoperative chemotherapy in Wilms’ tumour: results of an
International Society of Pediatric Oncology (SIOP) clinicaltrial.
J Clin Oncol 1983;1:604–10.
Tournade MF, Com-Nogue C, Voute PA, et al. Results of the
Sixth International Society of Paediatric Oncology Wilms’
Tumour Trial and Study: A risk adapted approach in
Wilms’tumour. J Clin Oncol 1993;11:1014–23.
Ehrlich PF, Hamilton TE, Gow K, et al. Surgical Protocol
Violations in Children with Renal Tumors Provides an
Opportunity to Improve Pediatric Cancer Care: A Report from
the Children’s Oncology Group. Pediatric blood & cancer.
;63(11):1905-10.
Jemal A, Siegel R, Ward E, Xu J, Thun MJ. Cancer statistics,
CA: a cancer journal for clinicians. 2007;57(1):43-66.
Rai AT, Moazam F. Malignant abdominal tumors in children.
JPMA. The Journal of the Pakistan Medical Association.
;46(8):168-71.
Breslow N, Olshan A, Beckwith JB, Green DM. Epidemiology
of Wilms tumor. Medical and pediatric oncology.
;21(3):172-81.
Prognosis for patients with stage III FH is best when treatment
includes either (a) dactinomycin, vincristine, doxorubicin,
and 10.8 Gy
Cassady JR, Tefft M, Filler RM, Jaffe N, Hellman S.
Considerations in the radiation therapy of Wilms' tumor.
Cancer. 1973;32(3):598-608.
Bhatnagar S. Management of Wilms' tumor: NWTS vs SIOP.
Journal of Indian Association of Pediatric Surgeons.
;14(1):6.
13. Ehrlich PF, Ritchey ML, Hamilton TE, Haase GM, Ou S,
Breslow N, Grundy P, Green D, Norkool P, Becker J,
Shamberger RC. Quality assessment for Wilms' tumor: a
report from the National Wilms' Tumor Study-5. J Pediatr
Surg. 2005;40:208–212.
Ritchey ML, Kelalis P, Breslow N, Etzioni R, Evans I, Haase
GM, D'Angio GJ. Surgical complications after nephrectomy
for Wilms tumor. Surg Gynecol Obstet. 1992;175:514.
Ritchey ML, Shamberger RC, Haase G, Horwitz J, Bergemann
TL. Surgical complications after primary nephrectomy for
Wilms' tumor: report from the National Wilms' Tumor Study
Group. J Am Col Surg.2001;192:63–68.
Godzinski J, Tournade MF, deKraker J, et al. Rarity of surgical
complications after postchemotherapy nephrectomy for
nephroblastoma. Experience of the International Society of
Paediatric Oncology-Trial and Study “SIOP-9”. International
Society of Paediatric Oncology Nephroblastoma Trial and
Study Committee. Eur J Pediatr Surg 1998;8(2):83-6.
Fuchs J, Kienecker K, Furtwängler R, Warmann SW, Burgher
D, Thuroff JW, Hager J, Graf N. Surgical aspects in the
treatment of patients with unilateral wilms tumor: a report
from the SIOP 93-01/German Society of Pediatric Oncology
and Hematology. Ann Surg. 2009;249:666–671.
Sen S , Kadamba P, Al-AbdulAaly M, Mammen KE, Ahmed
S. Results of Wilms' tumour management in two tertiary-care
hospitals in Asia. Pediatr Surg Int. 1998; 13(1):42-4.
Mitchell C, Pritchard-Jones K, Shannon Ret al.Immediate
nephrectomy versus preoperatice chemotherapy in the
management of non- metastatic wilms tumor: Results of a
randomized trial by the UK children’s Cancer Study Group.Eur
J Cancer. 2006;42(15):2554-62
Arya M, Shergill IS, Gommersall L, Barua JM, Duffy PG,
MushtaqI.Current trends in the management of Wilms'
tumour.BJU Int. 2006;97(5):899-900.
Tan XH et al Retrospective analysis to determine outcomes
of patients with bilateral Wilms tumor undergoing nephron
sparing surgery: 15-year tertiary single-institution experience.
Pediatr Surg Int. 2018;34(4):427-433
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