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Treatment of Wilms tumor according to SIOP 9 protocol in Casablanca, Morocco
Abdellah Madani1, Saadia Zafad, M'hamed Harif
1Hematology and Pediatric Oncology Department, Hôpital du 20 Août, Casablanca, Morocco. abdellah_md@yahoo.fr
Insights
Wilms tumor treatment in Morocco showed encouraging survival rates using the SIOP 9 protocol, with 5-year event-free survival at 77.4% for evaluable patients. Efforts are needed to reduce patient abandonment in developing countries.
Area of Science:
- Pediatric Oncology
- Clinical Research
- Cancer Treatment
Background:
- Childhood Wilms tumor presents significant challenges for pediatric oncologists in developing nations.
- This study reports on the characteristics and treatment outcomes of Wilms tumor patients managed in Morocco.
Purpose of the Study:
- To evaluate the efficacy of the SIOP 9 protocol for treating Wilms tumor in a Moroccan pediatric population.
- To analyze the clinical characteristics, treatment responses, and survival rates of these patients.
Main Methods:
- Eighty-six children diagnosed with Wilms tumor between 1989 and 2000 were included.
- Diagnosis utilized physical examination and abdominal ultrasound; metastatic work-up involved abdominal ultrasound and chest X-ray.
- Treatment followed the SIOP 9 Protocol without randomization.
Main Results:
- The median age was 36 months, with abdominal mass as the primary symptom in 84% of cases.
- Of 69 evaluable patients, 5-year event-free survival (EFS) was 77.4% and overall survival (OS) was 79%.
- Overall 5-year EFS for all patients was 56%, with 13 relapses and 3 treatment-related deaths.
Conclusions:
- The study demonstrates encouraging survival results for Wilms tumor treatment in a developing country setting.
- Further efforts are crucial to minimize patient dropout rates and improve overall outcomes.
Background:
Childhood Wilms tumor represents one of the challenge for pediatric oncologists in developing countries. We report the characteristics and treatment results of patients with Wilms tumor according to SIOP 9 protocol in Morocco.
Procedure:
From January 1989 to December 2000, 86 children with Wilms tumor were admitted. The diagnosis was based on physical exam and abdominal ultrasound. The metastatic work-up was based on abdominal ultrasound and chest X-ray.
Results:
The mean age was 36 months (3-120 months). The sex-ratio was 1. Abdominal mass was the main symptom at presentation (84 cases). There were 13 metastatic cases. Treatment applied was according to SIOP 9 Protocol without randomization. Local deases was present in 75 patients with stage I in 38 cases (50%), IIN0 in 4 cases (6%), IIN1 in 9 cases, and III in 24 cases (44%). The distribution of pathologic groups was: favorable in 4 cases, standard in 69 cases, and unfavorable anaplastic type in 2 cases. Sixty-nine patients were evaluable for therapeutic evaluation. Other patients were lost to follow-up. Three patients died of treatment related toxicity and 13 patients relapsed. With a median follow-up of 70 months, the 5-year EFS and 5 years overall survival for evaluable patients are 77.4% and 79%, respectively while the 5-year EFS for all patients was 56%.
Conclusion:
These results are encouraging for a developing country but special efforts should be done to reduce the rate of abandonment.
