WOFAPS 2025 8th World Congress of Pediatric Surgery

Zeenat Bhikhoo, Daffyd Davies

IWK Health Centre, Halifax, Nova Scotia, Canada

Purpose: Pediatric renal tumors remain a significant cause of morbidity and mortality worldwide. Management strategies vary across international oncology groups, often influenced by available resources. This study aimed to compare the epidemiology, management protocols, and outcomes of pediatric renal tumors at two institutions—one in a low- to middle-income country (LMIC) and the other in a high-income country (HIC)—to identify key differences and potential areas for global improvement.

Methods: A retrospective review was conducted of pediatric patients diagnosed with renal tumors over the past 10 years at two tertiary centers. Data collected included tumor type, stage at presentation, treatment protocols used, and outcomes. Comparisons were drawn between the two settings with respect to clinical characteristics and resource availability.

Results: Wilms tumor was the most common renal tumor at both institutions. Patients at the LMIC center more frequently presented with advanced-stage disease, likely due to delayed access to healthcare services. The LMIC site utilized the SIOP protocol, while the HIC followed COG guidelines. Mortality was higher in the LMIC cohort but remained within internationally reported ranges. Genetic testing was more routinely employed in the HIC, providing insights into associated mutations and risk stratification.

Conclusion: This comparative review underscores the disparities in presentation and outcomes of pediatric renal tumors between LMIC and HIC settings. Delayed access to care in LMICs contributes to more advanced disease at diagnosis and poorer outcomes. Enhanced healthcare infrastructure, early detection strategies, and equitable access to diagnostic and treatment modalities are essential to improve global outcomes. Bridging this gap is critical to ensuring that children receive optimal care, regardless of geographic or economic context.