Characteristics and clinical outcomes of children with Wilms’ tumour: A 15-year experience in a single centre in Nigeria

Background Wilms' tumor (WT) is the most common paediatric renal tumor and is one of the most treatment-responsive solid tumours. Survival from Wilms tumour (WT) in sub-Saharan Africa remains dismal as a result of late presentation, treatment abandonment and infrastructure deficit. The purpose of this study was to analyze the clinical outcome of children with Wilms tumour managed in a Nigerian referral centre over a 15-year period. Methods This is a retrospective study of children with WT (nephroblastoma) who were treated at our institution between January 2006 and December 2020. Clinical characteristics, treatments, and outcomes were analyzed. Results Thirty-five patients were identified. The median age at diagnosis was 36 months including 22(62.9%) females. Twenty-six (74.3%) had advanced (stage III & IV) disease. Confirmatory histology was available for 16 patients ((45.7%) among which 10(62.5%) were mixed type. The right kidney was affected in 18 patients (51.4%), left in 15(42.9%) and 2 were not documented. Preoperative chemotherapy was given in 22(62.9%) patients and 13(37.1) patients had primary nephrectomy. Eight (22.9%) patients died during treatment (from disease or treatment related causes), and one abandoned treatment. A total of 26 patients completed treatment. Out of these, 8(30.8%) were lost to follow up, four patients died and 14 (53.8%) patients survived at a median follow-up period of 18months. The survival decreased with advancing stages of the disease, p=0.002. Conclusions Majority of children with Wilms tumour in our practice presented with advanced disease. Death during treatment, treatment abandonment and lost to follow up were common. Level of Evidence Level II Retrospective Study.