Outcomes of Patients Managed for Wilms’ Tumor at Kenyatta National Hospital, Nairobi Kenya

Abstract

Objectives

Wilms' Tumor is a highly curable malignancy with excellent 5 year survival rates of >90% in the developed countries however, the developing countries continue to record dismal survival rates. This is due to late presentations, treatment abandonment and poor healthcare infrastructure .Over time, the developing countries have had better healthcare systems in terms of better imaging and diagnostics, better surgical skills, better access to care and infrastructure.

This study intended to assess the outcomes of patients managed at Kenyatta National Hospital, Kenya post these advancements

Methods

This was retrospective cross-sectional study of 51 patients with Wilms' Tumor diagnosed and treated 1st January 2015 to 31st December 2019 at Kenyatta National Hospital, Kenya. Inclusion criteria: all patients between 0-16 years with Wilms' Tumor. Exclusion criteria: none.

Data analysis was performed using STATA 11.0 and Kaplan Meier was used to determine the 2 year survival rate

Results

The mean age at diagnosis was 4.1.Male and female had an equal distribution. Most common presenting symptom was abdominal distention (which is usually associated with advanced disease).Most common imaging modality used to stage; Abdomen was CT scan and for chest imaging was a chest X-ray .Most patients had favorable histology. SIOP treatment protocol is the most common treatment protocol used.

Most patients presented with stage III disease(which is an advanced stage) and 98% of the patients studied were alive at 2 years post treatment .

Conclusion

Patients are still presenting with late stage disease however our survival rates have greatly improved and is approaching that of the developed countries. SIOP protocol has been adopted by most developing countries.