Survival of children with a Wilms tumor in Blantyre,Malawi |
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| Authors: | Trijn Israels Dalida Pidini Eric Borgstein Simon Bailey Clara Tump George Chagaluka |
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| Affiliation: | 1. Department of Paediatric Oncology and Academy Outreach, Princess Maxima Centre for Pediatric Oncology, Utrecht, The Netherlands;2. t.israels-3@prinsesmaximacentrum.nl;4. Department of Paediatrics, College of Medicine, Blantyre, Malawi;5. Department of Surgery, College of Medicine, Blantyre, Malawi;6. Department of Paediatric Oncology, Great North Childrens Hospital, Newcastle, UK;7. Department of Artificial Intelligence, University of Amsterdam, Amsterdam, The Netherlands |
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| Abstract: | AbstractWilms tumor (WT) has a survival rate above 90% in high income countries. Reported survival rates in sub-Saharan Africa are much lower and long-term outcome is not well known as follow-up is challenging. In Blantyre, Malawi, an adapted WT treatment guideline with preoperative chemotherapy, supportive care, and strategies to enable children and parents to complete treatment was introduced in 2006. Between 2006 and 2011, 73 children with a unilateral WT were treated. Follow-up, including home visits when needed, was done. Median follow-up time is 5 years (range 14–95 months). Two and five-year event free survivals are 46 and 42%. Causes of treatment failure are: 7% (5/73) abandonment of treatment, 15% (11/73) death during treatment and 30% (22/73) disease-related deaths (persistent disease and relapse). Long-term follow-up is challenging but necessary to be able to assess outcome and the true impact of interventions. |
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| Keywords: | Wilms tumor low income countries survival abandonment adapted treatment guidelines |
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