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Clinicoepidemiological Profile and Outcome of Children With Wilms Tumor in a Developing Country
1Department of Pediatrics, Pediatric Hematology-Oncology Unit, King George's Medical University, Lucknow, India.
Insights
Survival rates for pediatric Wilms tumor (WT) are poor in developing nations. This study in India shows a 74% 5-year survival for WT patients despite late presentation and advanced disease.
Area of Science:
- Pediatric Oncology
- Nephroblastoma Research
- Clinical Outcomes
Background:
- Wilms tumor (WT) outcomes have improved globally due to Pediatric Oncology advancements.
- Survival rates for WT remain poor in many developing countries, particularly India.
- Limited data exists on the clinical profile and outcomes of pediatric WT in India.
Purpose of the Study:
- To analyze the clinical profile and treatment outcomes of children with Wilms tumor (WT) in India.
- To assess survival rates and identify challenges in managing WT in a resource-limited setting.
Main Methods:
- Retrospective analysis of 108 children with WT treated between 2005 and 2014.
- Evaluation of presenting features, disease stages, treatment modalities, and survival data.
Main Results:
- The median age at presentation was 30 months with a male predominance (4:1 ratio).
- Abdominal mass (91%) was the most common symptom; most patients presented with Stage 2 (30%) or Stage 3 (35%) disease.
- Projected 5-year overall survival was 74% and event-free survival was 73%, despite 11 deaths during treatment and 14 relapses.
Conclusions:
- Children with WT in this Indian cohort presented late with advanced, large tumors.
- A multidisciplinary approach achieved reasonably good survival rates even in a resource-limited Indian setting.
- Late presentation and advanced disease pose surgical challenges in managing pediatric Wilms tumor.
Background:
Outcome of children with Wilms tumor (WT) has improved remarkably because of the advancements in Pediatric Oncology. However, in most developing countries survival rates are still poor. There is a paucity of data regarding the clinical profile and outcome of children with WT in India.
Methods:
Children with WT who were treated at our center between 2005 and 2014 were retrospectively analyzed.
Results:
Over the 10-year study period, 108 children with WT were treated in our unit. The median age at presentation was 30 months (male:female ratio of 4:1). Abdominal mass was the most common presenting feature (91%). The majority of children had stage 2 (30%) or stage 3 (35%) disease. Fifty-nine children had large or bilateral tumors requiring preoperative chemotherapy. Of the total 108 children, 11 died during primary treatment and 14 relapsed after completion of treatment. The projected 5-year overall survival is 74%, whereas the event-free survival is 73%.
Conclusions:
Children with WT in our setting present late with advanced disease and large tumors, which are technically difficult to deliver at surgery. With a multidisciplinary approach, reasonably good survival rates were achieved even in the resource-limited Indian scenario.
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