EN
TÜRKÇE
Oral Presentation - 112
A Prospective National Multicenter Observational study of Wilms tumor: Clinical characteristics, treatment and early outcomes
Abdulrasheed Nasir 1, Okechukwu Ekwunife 2, Taiwo Lawal 3, Omolara Williams 4, Emmanuel Ameh 5, Lukman ABDUR-RAHMAN 1, Justina Seyi-Olajide 6, Sebastian Ekenze 7, Awwal Abubakar 8, Lofty-John Anyanwu 9, Nurudeen Abdulraheem 1, Kefas Bwala 10, Abdulafeez Bello 11, Uchechukwu Ezomike 7, Taiwo Ibiyeye 12, Talib Sholadoye 13, Yetunde Israel-Aina 14, Olanrewaju Moses 15, Nasiru Musa 16, Mohammad Aminu 9, Olayinka Ibrahim 17, Adamu Adamu 18, Ijeoma Obianyo 7, Adekunle Abiodun 11, Jones Taiwo 12, Jideofor Ugwu 2, Oluseyi Ogunsua 13, Magdalene Odunvbun 14, Biobele Brown 3, Abdullahi Lawal 9, Mathew Durowaye 12, Victor Modekwe 2, Osasumwen Osagie 14, Yakubu Abubakar 13, Dare Olulana 3
1 Division of Paediatric Surgery, Department of Surgery, University of Ilorin and University of Ilorin Teaching Hopsital, Nigeria
2 Nnamdi Azikwe University Teaching Hospital, Nnewi
3 University College Hospital, Ibadan
4 Lagos State University Teaching Hospital, Lagos
5 National Hospital Abuja
6 Paediatric Surgery Unit, Lagos University Teaching Hospital, Lagos, Nigeria
7 Sub-Department of Paediatric Surgery, University of Nigeria Teaching Hospital Ituku-Ozalla Enugu, Nigeria
8 Modibbo Adama University Teaching Hospital, Yola, Adamawa State
9 Aminu Kano University Teaching Hospital, Kano
10 Abubakar Tafawa University Teaching Hospital, Bauchi
11 Federal Medical Center, Bida
12 Federal Medical Center, Lokoja
13 Ahmadu Bello University Teaching Hospital, Zaria
14 University of Benin Teaching Hospital, Benin-City
15 Federal Medical Center, Abeokuta
16 Usmanu Danfodio University Teaching Hospital, Sokoto
17 UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN, NIGERIA
18 Abubakar Tafawa Balewa University Teaching Hospital, Bauchi
Purpose: Despite ongoing efforts to improve the outcome of Wilms tumor (WT), epidemiology data on Wilms tumor in Nigeria remain limited. This study aimed to evaluate the clinical characteristics, treatment, and early outcomes.
Methods: This was a prospective observational multicenter study fifteen tertiary hospitals across Nigeria’s six geopolitical zones from April 2022 to April 2023. Children aged less than 16years newly diagnosed or on treatment for Wilms tumor were enrolled. Data collected using a standardized case report form included demographics, clinical presentation, histologic subtype, staging, treatment modality and outcomes. Primary endpoints included treatment completion and at least 12-month survival.
Results: A total of 70 children treated for Wilms tumor were included with 54% female, presenting at a median age of 39.6 months. 58 cases (82%) were 2years and above. Most common presentations were abdominal mass in 67 children (95.7%), weight loss in 48(68.6%) and abdominal pain in 43(62.4%). The median duration of symptoms was 60days. Median maximum tumor diameter at diagnosis was 15.5 cm and 53(75.7%) of patients had advanced disease. Preoperative chemotherapy was given to 57(81.4%) patients. Nephrectomy was performed in 55(78.6%) of patients, of whom 17.1% had a tumor rupture. Treatment abandonment occurred in 13(18.6%) patients and 13(18.6%) patients died during treatment. Only 44(62.9%) of children completed treatment. Out of these 44, disease relapse occurred in 5(11.4%, all died) and 5(11.4%) died of disease progression. Twenty-nine (65.9%) of children are alive at median follow period of 13months.
Conclusion: This first national prospective study on Wilms tumor in Nigeria reveals high rate of treatment abandonment and death during care. The mortality rate remains high. We recommend psychosocial and financial support to families and adoption context appropriate protocol and collaboration with high-income oncology centers for capacity building.