Wilms tumour among children attending Mbarara Regional Referral Hospital: Clinico-pathological characteristics and outcome at the end of treatment

Abstract

Background: Wilms tumour (WT) is the commonest malignant renal tumour in children and most common solid tumour in Africa. In Sub-Sa¬haran Africa it is the commonest intra-abdominal tumour. WT is the commonest abdominal solid tumour in children in Mbarara Regional Referral Hospital (MRRH). Survival is determined by tumour histology, tumour biology, stage at diagnosis and surgery. In our settings other factors that may determine treatment outcome include; availability of chemotherapy and radiotherapy, co-mor¬bidity, blood transfusion and anaesthesia. There is however no information regarding the clinico-pathological characteristics and treatment outcome of WT in MRRH. This study therefore set out to determine clinico-pathological characteristics of WT and end of treatment outcome among children attending this hospital. Methods: A retrospective medical record review of all children diagnosed with WT at MRRH between January 2014 and March 2016 was done. Ten patients who had been diagnosed with WT between April 2016 and December 2016 and also receiving treatment at MRRH were recruited prospectively into the study. Data on various socio-demographics, clinical findings, histological characteris¬tics and treatment outcome were collected. For data collected retrospectively patients were called in for follow up. Results: Records of 14 patients were reviewed retrospectively, and 10 patients were recruited (prospectively). Of these two, were lost to follow up. Male to female ratio was 1:1. Mean age at diagnosis was 46 months. All the patients presented with an abdominal mass. Sixty-seven percent presented in the pathological stage I and II of WT. Sixty-seven percent of the patients had unfavourable histology, and of these, 63% had diffuse anaplasia. Only 59% were alive at the end of treatment. Conclusions: Our patients are similar with regard to gender ratio, mean age at diagnosis, age distribution as described in literature. However, our patients differ in histological characteristics with a big proportion having anaplasia compared to WT studies done elsewhere. Majority of the patients were alive at the end of treatment