Wilms tumor survival in Kenya.

Axt J, Abdallah F, Axt M, Githanga J, Hansen E, Lessan J, Li M, Musimbi J, Mwachiro M, Newton M, Ndung'u J, Njuguna F, Nzioka A, Oruko O, Patel K, Tenge R, Ukoli F, White R, O'Neill JA, Lovvorn HN
J Pediatr Surg. 2013 48 (6): 1254-62

PMID: 23845615 · PMCID: PMC3710438 · DOI:10.1016/j.jpedsurg.2013.03.021

PURPOSE - Survival from Wilms Tumor (WT) exceeds 90% at 5 years in developed nations, whereas at last report, 2-year event-free survival (EFS) in Kenya reached only 35%. To clarify factors linked to these poor outcomes in Kenya, we established a comprehensive web-based WT registry, comprised of patients from the four primary hospitals treating childhood cancers.

MATERIALS AND METHODS - WT patients diagnosed between January 2008 and January 2012 were identified. Files were abstracted for demographic characteristics, treatment regimens, and enrollment in the Kenyan National Hospital Insurance Fund (NHIF). Children under 15 years of age having both a primary kidney tumor on imaging and concordant histology consistent with WT were included.

RESULTS - Two-year event-free survival (EFS) was 52.7% for all patients (n=133), although loss to follow up (LTFU) was 50%. For the 33 patients who completed all scheduled standard therapy, 2-year EFS was 94%. Patients enrolled in NHIF tended to complete more standard therapy and had a lower hazard of death (Cox 0.192, p < 0.001).

CONCLUSION - Survival of Kenyan WT patients has increased slightly since last report. Notably, WT patients completing all phases of standard therapy experienced 2-year survival approaching the benchmarks of developed nations. Efforts in Kenya should be made to enhance compliance with WT treatment through NHIF enrollment.

Copyright © 2013 Elsevier Inc. All rights reserved.

MeSH Terms (24)

Adolescent Adrenalectomy Chemotherapy, Adjuvant Child Child, Preschool Combined Modality Therapy Disease-Free Survival Female Follow-Up Studies Humans Infant Infant, Newborn Internet Kenya Kidney Neoplasms Male Neoadjuvant Therapy Neoplasm Staging Radiotherapy, Adjuvant Registries Retrospective Studies Survival Analysis Treatment Outcome Wilms Tumor

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