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Updated: Feb 19, 2026
Ex Vivo Treatment Response of Primary Tumors and/or Associated Metastases for Preclinical and Clinical Development of Therapeutics
Published on: October 2, 2014
Wilms Tumor Treatment Outcomes: Perspectives From a Low-Income Setting
Festus Njuguna1, Hugo A Martijn1, Robert Tenge Kuremu1
1, , , , , and Moi University, Eldoret, Kenya; , , and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , , and , Indiana University School of Medicine, Indianapolis, IN.
Insights
Pediatric Wilms tumor survival is poor in Kenya, with treatment abandonment being the main cause of failure. Advanced stage at diagnosis significantly impacts outcomes for children with this common childhood kidney cancer.
Area of Science:
- Pediatric Oncology
- Global Health
- Cancer Epidemiology
Background:
- Wilms tumor is the most common childhood kidney cancer.
- Survival rates differ significantly between high-income countries (approx. 90%) and low-income countries (less than 50%).
Purpose of the Study:
- To assess treatment outcomes for pediatric Wilms tumor patients at a Kenyan academic hospital.
- To identify factors influencing treatment success and failure in this population.
Main Methods:
- Retrospective review of medical records for children diagnosed with Wilms tumor between 2010 and 2012.
- Data collection included treatment outcomes, sociodemographic, and clinical characteristics.
Main Results:
- Of 39 patients, 41% achieved event-free survival, while 31% abandoned treatment, 23% died, and 5% had progressive/relapsed disease.
- Most patients presented with advanced stage disease (Stage III: 43%, Stage IV: 40%).
- Disease stage significantly impacted outcomes (P=.014) and event-free survival (P<.001), with low-stage disease associated with better survival and high-stage with higher mortality.
Conclusions:
- Wilms tumor survival in Kenya is substantially lower than in high-income nations.
- Treatment abandonment is the primary driver of treatment failure.
- Early diagnosis and stage at presentation are critical determinants of treatment outcomes and survival for pediatric Wilms tumor.
Purpose:
Wilms tumor is the commonest renal malignancy in childhood. Survival in high-income countries is approximately 90%, whereas in low-income countries, it is less than 50%. This study assessed treatment outcomes of patients with Wilms tumor at a Kenyan academic hospital.
Patients And Methods:
We conducted a retrospective medical record review of all children diagnosed with Wilms tumor between 2010 and 2012. Data on treatment outcomes and various sociodemographic and clinical characteristics were collected.
Results:
Of the 39 patients with Wilms tumor, 41% had event-free survival, 31% abandoned treatment, 23% died, and 5% had progressive or relapsed disease. Most patients presented at an advanced stage: stage I (0%), II (7%), III (43%), IV (40%), or V (10%). The most likely treatment outcome in patients with low-stage (I to III) disease was event-free survival (67%), whereas in those with high-stage (IV to V) disease, it was death (40%). No deaths or instances of progressive or relapsed disease were recorded among patients with low-stage disease; their only reason for treatment failure was abandonment of treatment. Stage of disease significantly affected treatment outcomes (P = .014) and event-free survival estimates (P < .001). Age at diagnosis, sex, duration of symptoms, distance to hospital, and health insurance status did not statistically significantly influence treatment outcomes or event-free survival estimates.
Conclusion:
Survival of patients with Wilms tumor in Kenya is lower compared with that in high-income countries. Treatment abandonment is the most common cause of treatment failure. Stage of disease at diagnosis statistically significantly affects treatment outcomes and survival.
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