| dc.description.abstract |
Wilms tumor is the most common primary renal
malignancy in children. It accounts for 5% of
childhood malignancies.1 It is thought to arise
from nephrogenic rests, which are foci of persis tent metanephrenic cells.2 Survival rates have
improved from 20% in the 1960s to approximately
90% currently in high-income countries; middle income countries have survival rates of approxi mately 80%.2,3 This has been achieved through
cooperative study groups as well as use of multi modal approaches to therapy. The two main study
groups that have been involved are the National
Wilms’ Tumor Study Group and the International
Society of Pediatric Oncology (SIOP).2,4,5
Low-income countries, however, have survival
rates between 20% and 50%.1-3 Reasons for the
low survival in low-income countries include lim ited access to proper medical care as a result of
lack of facilities for treatment, shortage of person nel, long distances to treatment centers, poor
infrastructure, and limited public transport facili ties. These factors lead to late presentation, which
also affects outcomes. Other contributors to the
low survival include lack of health insurance,
abandonment of treatment, and lack of a multi disciplinary approach to the management of
patients. Treatment includes surgery and che motherapy, as well as radiotherapy for metastatic
disease.2,3,5
The aims of our study were to assess the treatment
outcomes of children presenting with Wilms tumor
at a Kenyan academic hospital and to evaluate the
influence of various socio demographic and clini cal characteristics (eg, age at diagnosis, sex, du ration of symptoms, stage of disease, distance to
hospital, and health insurance status) on treatment outcome |
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