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Wilms tumour treatment in Sudan: A 10-year single-centre experience
Mohammed Abdalla1, Somaya Hameed2
1Faculty of Medicine, Pediatric Department, Khartoum Oncology Hospital (KOH), University of Khartoum, Khartoum, Sudan.
Insights
Establishing a pediatric oncology service significantly improved Wilms tumor survival in Sudan to 43%. However, high treatment abandonment rates persist, highlighting the need for further improvements in pediatric cancer care.
Area of Science:
- Pediatric Oncology
- Cancer Epidemiology
- Global Health
Background:
- Wilms tumor survival in Sudan was critically low at 11% in 2008.
- This study assesses the impact of a dedicated pediatric oncology service on Wilms tumor outcomes.
- Identifies key challenges in treating pediatric kidney cancer in the region.
Purpose of the Study:
- To investigate Wilms tumor treatment outcomes over a decade at Khartoum Oncology Hospital.
- To evaluate the effectiveness of a newly established pediatric oncology service.
- To identify factors influencing survival and treatment abandonment.
Main Methods:
- Retrospective analysis of 143 Wilms tumor patients from 2005-2014.
- Treatment followed the National Wilms Tumor Study Group (NWTS) IV protocol.
- Outcomes analyzed for overall survival and event-free survival, correlated with patient demographics and disease characteristics.
Main Results:
- Mean patient age at diagnosis was 3.5 years; 83% presented with advanced stage disease (3 & 4).
- A significant treatment abandonment rate of 42.6% was observed.
- Event-free survival was 75.6% for completers versus 43.4% overall.
Conclusions:
- Pediatric oncology service establishment increased Wilms tumor survival to 43%.
- High treatment abandonment remains a critical barrier to improving outcomes.
- Further interventions are needed to reduce abandonment and enhance surgical pediatric oncology services.
Background:
In Sudan, the survival of Wilms tumour was reported as 11% in a 2008 study. The impact of establishing paediatric oncology service on survival is studied, and the obstacles of treating Wilms tumour patients were identified.
Aim:
This study investigates Wilms tumour treatment outcomes over 10 years at Khartoum Oncology Hospital (KOH).
Methods:
All Wilms tumour patients from 2005 to 2014 were analysed retrospectively. Patients received treatment based on the NWTS IV protocol. Patients were analysed for overall survival, and event-free survival and these outcomes were correlated with age, sex, stage at presentation, and histology.
Results:
We analysed 143 files of Wilms tumour patients. The male to female ratio is 1.75. The mean age of patients at diagnosis is 3.5 years. The follow-up period is 5 years. Most patients (83%) had advanced disease stage 3, and 4. There is a very high abandonment rate 61 (42.6%). The event-free survival among patients who completed treatment is 75.6%, and is 43.4% for all the (143) patients.
Conclusions:
"After initiation of the paediatric oncology service, the survival of Wilms tumour in Sudan is 43%. Abandonment of treatment remains high. Opportunity remains to reduce abandonment and establish a surgical paediatric oncology service to improve outcomes further."
