Age is not a prognostic factor in children with Wilms tumor beyond stage I in Africa

Area of Science:

• Pediatric Oncology
• Cancer Research
• Clinical Studies

Background:

• Favorable histology (FH) Wilms tumor in patients under 4 years is associated with a survival advantage.
• Children over 10 years with Wilms tumor often present with diffuse anaplasia, indicating a poorer prognosis.

Purpose of the Study:

• To investigate if older patients (>8 years) with advanced stage Wilms tumors (II-V) experience a poorer prognosis compared to younger children (<8 or <4 years).

Main Methods:

• A case-control study involving 19 patients over 8 years old with Wilms tumor (stages II-V) matched with two controls each (ages 0-3 and 4-7 years).
• All patients received neo-adjuvant chemotherapy and supportive care, with treatment tailored post-surgery based on stage and histology.
• Overall Survival (OS) and Event-Free Survival (EFS) at 5 years were compared across age groups.

Main Results:

• The study included 19 patients in each age group (over 8, 4-7, and 0-3 years), with tumor stages ranging from II to V.
• Overall survival was 80.8% and EFS was 79.2% for the entire cohort.
• No statistically significant differences in outcomes were observed between the different age groups.

Conclusions:

• The survival advantage seen in younger children (<4 years) with stage I FH Wilms tumor was not evident in higher stages.
• While age did not significantly impact prognosis, a trend towards better outcomes was noted in the youngest group (<4 years).