Introduction: Wilms tumor is the second most common abdominal tumor in the pediatric age group and accounts for more than 90% of renal tumors in pediatrics. Even though the described survival rate is greater than 90%, we found that it only reaches 70% among our patients. Therefore, we aim to evaluate which are the factors associated with these unfavorable results, in order to implement measures to improve the survival of our patients. Methods: An observational, cross-sectional study was conducted in two high-level care centers, which included a sample of 84 patients under 15 years of age, diagnosed with Wilms tumor. Results: Factors significantly associated with an increased likelihood of death were failure to complete the chemotherapy protocol (odds ratio [OR] = 34; 95% confidence interval [CI] = 3.7–312; P = 0.000) and tumor recurrence (OR = 35.7; 95% CI = 6.9–184; P = 0.000). Other minor factors with certain impact were bilateral presentation (OR = 4.1; 95% CI = 0.6–5.5; P = 0.147), surgical complications (OR = 3.2; 95% CI = 0.7–14.6; P = 0.136), lymph node involvement on CT scan (OR 2.4; 95% CI 0.7–8.4; P = 0.139), and distant metastases (OR = 2.5; 95%CI = 0.7–9; P = 0.143). Discussion: The survival of our patients with Wilms tumor is lower than that reported in literature is associated with factors like failure to complete chemotherapy, recurrence, and the need for bilateral surgery.
Mejía F, 2017, Wilms Tumor (nephroblastoma), in Pediatric Surgery, 2nd Edition, Antioquia University Publishing House, Medellín, 365–371.
Gurney JG, Severson RK, Davis S, et al., 1995, Incidence of Cancer in Children in the United States. Sex-, Race-, and 1-Year Age-Specific Rates by Histologic Type. Cancer, 75: 2186–2195. https://doi.org/10.1002/1097-0142(19950415)75:8<2186::aid-cncr2820750825>3.0.co;2-f
Stiller CA, Parkin DM, 1990, International Variations in the Incidence of Childhood Renal Tumors. Br J Cancer, 62: 1026–1030. https://doi.org/10.1038/bjc.1990.432
National Institute of Cancerology (ESE), 2018, Statistical Yearbook 2015, Bogota, 120. http://www.cancer.gov.co/files/libros/archivos/2015
Herrera-Toro NH, Peña-Aguirre L, Arango-Rave ME, 2019, Wilms Tumor: 12-Year Experience in Two High-Level Hospitals in Medellín, Colombia. Iatreia, 32: 82–91. https://doi.org/10.17533/udea.iatreia.13
D’Angelo P, Di Cataldo A, Terenziani M, et al., 2017, Factors Possibly Affecting Prognosis in Children with Wilms’ Tumor Diagnosed Before 24 Months of Age: A Report from the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP) Wilms Tumor Working Group. Pediatric Blood & Cancer, 64: 12–64. https://doi.org/10.1002/pbc.26644
Aronson DC, Hadley GP, 2014, Age is not a Prognostic Factor in Children with Wilms Tumor Beyond Stage I in Africa. Pediatric Blood & Cancer, 61: 987–989. https://doi.org/10.1002/pbc.24948
Reinhard H, Semler O, Bu?rger D, et al., 2004, Results of the SIOP 93-01/GPOH Trial and Study for the Treatment of Patients with Unilateral Nonmetastatic Wilms Tumor. Klin Padiatr, 216: 132–140. https://doi.org/10.1055/s-2004-822625
Dome JS, Perlman EJ, Graf N, 2014, Risk Stratification for Wilms Tumor: Current Approach and Future Directions. Am Soc Clin Oncol, 34: 215–223. https://doi.org/10.14694/EdBook_AM.2014.34.215
Uba AF, Chirdan LB., 2007, Childhood Wilms’ Tumour: Prognostic Factors in North Central Nigeria. West Afr J Med, 26: 222–225. https://doi.org/10.4314/wajm.v26i3.28314
Ekenze SO, Agugua-Obianyo NEN, Odetunde OA, 2006, The Challenge of Nephroblastoma in a Developing Country. Ann Oncol, 17: 1598–1600. https://doi.org/10.1093/annonc/mdl167
Axt J, Abdallah F, Axt M, et al., 2013, Wilms Tumor Survival in Kenya. J Pediatr Surg, 48: 1254–1262. https://doi.org/10.1016/j.jpedsurg.2013.03.021
Atanda AT, Anyanwu L-JC, Atanda OJ, et al., 2015, Wilms’ Tumour: Determinants of Prognosis in an African Setting. Afr J Paediatr Surg, 12: 171–176. https://doi.org/10.4103/0189-6725.170185
Abubakar AM, Bwala JK, Abdur-Rahman LO, et al., 2010, Outcome of Treatment of Nephroblastoma in Nigerian Children. Afr J Paediatr Surg, 7: 45–52.
Osuoji RI, Williams OM, Ajai OT, et al., 2011, Wilms’ Tumour: Experience in a Developing Tertiary Centre in Nigeria. East Cent Afr J Surg, 16: 123–128.
Sangkhathat S, Chotsampancharaen T, Kayasut K, et al., 2008, Outcomes of Pediatric Nephroblastoma in Southern Thailand. Asian Pac J Cancer Prev, 9: 643–647.
Saltzman AF, Carrasco A, Amini A, et al., 2018, Patterns of Lymph Node Sampling and the Impact of Lymph Node Density in Favorable Histology Wilms Tumor: An Analysis of the National Cancer Database. J Pediatr Urol, 14: 161.e1–161.e8. https://doi.org/10.1016/j.jpurol.2017.09.025
Zhuge Y, Cheung MC, Yang R, 2011, Improved Survival with Lymph Node Sampling in Wilms Tumor. J Surg Res, 167: e199–e203. https://doi.org/10.1016/j.jss.2010.12.026
Kutluk T, Varan A, Bu?yu?kpamukçu N, et al., 2006, Improved Survival of Children with Wilms Tumor. J Pediatr Hematol Oncol, 28: 423–426.
Breslow N, Sharples K, Beckwith JB, et al., 1991, Prognostic Factors in Nonmetastatic, Favorable Histology Wilms’ Tumor. Results of the Third National Wilms’ Tumor Study. Cancer, 68: 2345–2353. https://doi.org/10.1002/1097-0142(19911201)68:11<2345::aid-cncr2820681103>3.0.co;2-t
Fernandez CV, Mullen EA, Chi Y-Y, et al., 2018, Outcome and prognostic factors in stage III favorable-histology Wilms Tumor: A report from the Children’s Oncology Group Study AREN0532. J Clin Oncol, 36: 254–261. https://doi.org/10.1200/JCO.2017.73.7999
Kinoshita Y, Suminoe A, Inada H, et al., 2012, The Prognostic Significance of Blastemal Predominant Histology in Initially Resected Wilms’ Tumors: a report from the Study Group for PediatricSolid Tumors in the Kyushu Area, Japan. J Pediatr Surg, 47: 2205–2209. https://doi.org/10.1016/j.jpedsurg.2012.09.009
Aoba T, Urushihara N, Fukumoto K, et al., 2012, Relapse of Unilateral Favorable Histology Wilms’ Tumor: Significant Clinic Opathological Factors. J Pediatr Surg, 47: 2210–2215. https://doi.org/10.1016/j.jpedsurg.2012.09.010
Vujani? GM, Gessler M, Ooms AHAG, et al., 2018, The UMBRELLASIOP-RTSG 2016 Wilms tumour pathology and molecularbiology protocol. Nat Rev Urol, 15: 693–701. https://doi.org/10.1038/s41585-018-0100-3
Zani A, Schiavetti A, Gambino M, et al., 2005, Long-term Outcome of Nephron Sparing Surgery and Simple Nephrectomy for Unilateral Localized Wilms Tumor. J Urol. 173: 946–948. https://doi.org/10.1097/01.ju.0000152580.90861.d3
Sarhan OM, El-Baz M, Sarhan MM, et al., 2010, Bilateral Wilms’ Tumors: Single-Center Experience with 22 Cases and Literature Review. Urology, 76: 946–951. https://doi.org/10.1016/j.urology.2010.03.055