Wilms tumour: Long-term survival of patients treated at Mbingo Baptist Hospital in Cameroon between 2007 and 2012

Abstract

Background:The survival rate of Wilms tumour (WT) in low-income sub-Saharan countries in Africa is below 50%. Thirty-five consecutive children diagnosed with WT between 2007 and 2012 at Mbingo Baptist Hospital, Cameroon, were observed in this study and treated with a modified International Society of Paediatric Oncology (SIOP) treatment protocol.Aim: Our objective was to achieve a significant overall cure rate in patients with WT.Setting: This report describes the long-term outcome of patients treated at Mbingo Baptist hospital (MBH) in northwest Cameroon.Method: This consisted of preoperative chemotherapy, nephrectomy and post-operative chemotherapy depending on the stages of the disease and histological findings. Radiotherapy was not available. The diagnosis and staging was based on abdominal ultrasound (US), chest X-Ray and the histological findings at nephrectomy and surgery and/or fine needle aspirate (FNA). The cohort included 17 boys and 18 girls with a median age of 3.5 years (range 6 months to 9 years). The surgical stage distribution was: stage I = 9; II = 3; III = 5; IV = 12; V = 3; undetermined = 3 patients.Results: Three guardians refused surgery; there were three deaths related to surgery and two deaths during preoperative chemotherapy. All relapses occurred within 12 months. The survival rate was significantly better in stages I and II than in stages III and IV of cancer. Two of the three patients with bilateral WT are long-term survivors. The overall projected survival rate after a median follow-up of 84 months (range 4-125 months) was 44%. One patient in remission was lost to follow-up after 4 months. All patients admitted with a diagnosis of WT were included in the Kaplan-Meier survival analysis. Conclusion:With this treatment schedule followed for more than 50% of the patients, it can be concluded that obtaining consent from every guardian for nephrectomy and preventing deaths related to surgery and chemotherapy could improve the overall survival rate of all patients diagnosed with WT.

Two decades of childhood cancer care in Cameroon: 2000–2020

“…Two of the reports addressed awareness, 7,11 10 addressed diagnosis, registration, and epidemiology, 5,[12][13][14][15][16][17][18][19][20] 18 addressed management and outcomes, 7,14,16,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] four addressed supportive care, [36][37][38][39] five addressed palliative care, [40][41][42][43][44] four addressed advocacy and F I G U R E 1 Map of Cameroon showing location of dedicated pediatric oncology units partnerships, 35,37,45,46 and one addressed T&CM 39 (Supporting Information File S1).…”

“…Two of the reports addressed awareness, 7,11 10 addressed diagnosis, registration, and epidemiology, 5,12–20 18 addressed management and outcomes, 7,14,16,21–35 four addressed supportive care, 36–39 five addressed palliative care, 40–44 four addressed advocacy and partnerships, 35,37,45,46 and one addressed T&CM 39 (Supporting Information File S1).…”

“…However, this report only included standard‐risk patients and excluded patients who died before or after surgery and those who abandoned treatment 32 . The first report on survival of nephroblastoma in MBH, in Northwest Cameroon, shows a rate of 44% with a median follow‐up of 84 months (7 years) for 35 patients treated by means of both chemotherapy and surgery 34 …”

“…32 The first report on survival of nephroblastoma in MBH, in Northwest Cameroon, shows a rate of 44% with a median followup of 84 months (7 years) for 35 patients treated by means of both chemotherapy and surgery. 34 The CBCHS pediatric oncology units collaborated in the Collabora- and highly active ART (HAART). 28 A 5-year patient survival rate of 82% has been reported for a cohort of 26 patients with Hodgkin disease.…”

Factors of Nephroblastomas’ Relapse in Children at the Academic Hospital Gabriel Toure, Bamako, Mali

“…The management of Wilms tumor combines chemotherapy, surgery, and radio Open Journal of Pediatrics therapy. Surgery is always preceded by chemotherapy to reduce the tumor mass, facilitate its excision and reduce hemorrhage as well as the risk of swarming of malignant cells [14]. This chemotherapy is started on clinical and radiological ar- Post-operative chemotherapy aims to reduce the incidence of secondary metastases and local recurrences.…”