NUTRITION, MORBIDITY, AND SURVIVAL IN SOUTH AFRICAN CHILDREN WITH WILMS' TUMOR

Fifty-nine children with Wilms' tumor (WT) were divided into a normal or poorly nourished group according to anthropometric parameters. The 2 groups were compared for morbidity and survival. There was no difference in the median age or stage of disease in the 38 well nourished and 21 poorly nourished children. There was no difference in the number of children in the normal or poorly nourished group who developed a raised urea or creatinine level, febrile episodes, severe stomatitis, varicella, or upper or lower respiratory infections, or who needed intravenous antibiotics, parenteral nutrition, or red cell and platelet transfusions. Projected survival rate was 56 and 74% for normal and poorly nourished children, respectively (p=.3). Poor nutrition at diagnosis, as determined by anthropometry, had no effect on the morbidity of treatment or survival in children with WT. Based on these results, selective dietary supplementation instead of routine intensive parenteral nutritional support for all children with WT is recommended in countries with limited resources.