Tenge C N, Were P A, Aluoch L H, Wekesa J W, Patel K, Kuremu R T
Department of Child Health and Paediarics, Moi University, School of Medicine, Eldoret, Kenya.
East Afr Med J. 2012 Apr;89(4):121-7.
Wilms' tumour is a common malignant neoplasm of the kidney and is ranked among the top six solid tumours in children in Kenya. Despite its rapid growth and therefore debilitating effects on its victims, it is one tumour that has shown good response to combined modality approach to its treatmentwith encouraging possibilities of survival even in resource poor settings.
To evaluate the management and outcome of patients with Wilms'tumour attended to at Moi Teaching and Referral Hospital (MTRH) during the period between January 2000 and December 2007.
Retrospective Study.
The Paediatric Oncology Service (Oncology unit in the Paediatric Ward, the Paediatric Surgical Ward and the Outpatient Oncology Clinic) at the Moi Teaching and Referral Hospital, Eldoret, Kenya.
Information of 45 patients diagnosed with Wilms' tumour was analysed. Forty two (93%) of the patients were referrals from various health facilities in the region. Twenty three (51%) were male and 34 (76%) were aged less than 48 months. Twenty five (56%) had the left kidney affected, 19 (42%) the right kidney and one (2%) bilateral. All the 45 (100%) had an abdominal ultrasound done but none had exhaustive investigations done to stage the disease. Only eight (18%) of the patients had a medical insurance cover. Fourty one (91%) of the patients received specific cancer treatment with 28 (62%) getting combined modality treatment. Nineteen (42%) were lost to follow up. Thirty (67%), 21 (47%), 15 (33%) and 13 (29%) patients were alive six months, one year, two years and three years respectively from the time of diagnosis. 29% survived beyond three years of diagnosis.
Staging of Wilms tumour fell short of the expected. Neo-adjuvant chemotherapy reduced morbidity and mortality of patients managed for Wilms' tumour. Loss to follow up and cost of treatment had a negative impact on the outcome, a situation that requires to be improved.
肾母细胞瘤是一种常见的肾脏恶性肿瘤，在肯尼亚儿童实体瘤中排名前六位。尽管其生长迅速，对患者造成严重影响，但它是一种对综合治疗方法反应良好的肿瘤，即使在资源匮乏的环境中也有令人鼓舞的生存可能性。
评估2000年1月至2007年12月期间在莫伊教学与转诊医院（MTRH）接受治疗的肾母细胞瘤患者的管理情况和治疗结果。
回顾性研究。
肯尼亚埃尔多雷特莫伊教学与转诊医院的儿科肿瘤服务部门（儿科病房的肿瘤科、儿科外科病房和门诊肿瘤科）。
分析了45例诊断为肾母细胞瘤患者的信息。其中42例（93%）患者是由该地区各种医疗机构转诊而来。23例（51%）为男性，34例（76%）年龄小于48个月。25例（56%）左侧肾脏受累，19例（42%）右侧肾脏受累，1例（2%）双侧受累。所有45例（100%）患者均进行了腹部超声检查，但均未进行全面检查以对疾病进行分期。只有8例（18%）患者有医疗保险。41例（91%）患者接受了特定的癌症治疗，其中28例（62%）接受了综合治疗。19例（42%）患者失访。从诊断时起，分别有30例（67%）、21例（47%）、15例（33%）和13例（29%）患者在6个月、1年、2年和3年时存活。29%的患者在诊断后存活超过3年。
肾母细胞瘤的分期未达预期。新辅助化疗降低了肾母细胞瘤患者的发病率和死亡率。失访和治疗费用对治疗结果有负面影响，这种情况需要改善。
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