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Introduction
Wilms’ tumor is the second most common childhood cancer in Africa and while survival from Wilms’ tumor exceeds 90% at 5 years in developed nations, the one year recurrence free survival at KCMC was 35.9% 8 years back. The purpose of the present study was to identify the gaps in the management of Wilms’ tumor which resulted in an inferior outcome and to see if there is any improvement since the last study and to come up with recommendations to improve the outcome of Wilms’ tumor.
Patients and Methods
This was a retrospective hospital based study at Urology Institute of Kilimanjaro Christian Medical Centre. Patients operated for Wilms’ tumor between January 2006 and December 2013 were identified and the medical records of the 46 patients eligible for the study retrieved. The relevant information was entered into the prepared data collection format. The data was cleaned, summarized and analysed using SPSS version 17.
Results
Patients with Wilms’ tumor presented late to KCMC. There was no undue delay in reaching at diagnosis. From the 46 total number of patients in this study 20 (43.5%) of patients received neoadjuvant chemotherapy while 26 (56.5%) had an upfront nephrectomy. The one year recurrence free survival was 32.6% with a high rate of lost to follow up (41.3%), perioperative mortality of (10.8%), and recurrence rate of (26.8%).
Conclusion
There was no improvement in the outcome of WT at KCMC compared to the last report 8 years back. Patients still present late to health institutions, there is high rate of lost to follow up and the prognosis of Wilm’s tumor in this part of Africa is still dismal.
Key words; Wilm’s tumor, presentation, outcome |
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