Njuguna Festus, Martijn Hugo A, Kuremu Robert Tenge, Saula Peter, Kirtika Patel, Olbara Gilbert, Langat Sandra, Martin Steve, Skiles Jodi, Vik Terry, Kaspers Gertjan J L, Mostert Saskia
, , , , , and Moi University, Eldoret, Kenya; , , and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , , and , Indiana University School of Medicine, Indianapolis, IN.
J Glob Oncol. 2016 Dec 21;3(5):555-562. doi: 10.1200/JGO.2016.005389. eCollection 2017 Oct.
Wilms tumor is the commonest renal malignancy in childhood. Survival in high-income countries is approximately 90%, whereas in low-income countries, it is less than 50%. This study assessed treatment outcomes of patients with Wilms tumor at a Kenyan academic hospital.
We conducted a retrospective medical record review of all children diagnosed with Wilms tumor between 2010 and 2012. Data on treatment outcomes and various sociodemographic and clinical characteristics were collected.
Of the 39 patients with Wilms tumor, 41% had event-free survival, 31% abandoned treatment, 23% died, and 5% had progressive or relapsed disease. Most patients presented at an advanced stage: stage I (0%), II (7%), III (43%), IV (40%), or V (10%). The most likely treatment outcome in patients with low-stage (I to III) disease was event-free survival (67%), whereas in those with high-stage (IV to V) disease, it was death (40%). No deaths or instances of progressive or relapsed disease were recorded among patients with low-stage disease; their only reason for treatment failure was abandonment of treatment. Stage of disease significantly affected treatment outcomes ( = .014) and event-free survival estimates ( < .001). Age at diagnosis, sex, duration of symptoms, distance to hospital, and health insurance status did not statistically significantly influence treatment outcomes or event-free survival estimates.
Survival of patients with Wilms tumor in Kenya is lower compared with that in high-income countries. Treatment abandonment is the most common cause of treatment failure. Stage of disease at diagnosis statistically significantly affects treatment outcomes and survival.
肾母细胞瘤是儿童期最常见的肾脏恶性肿瘤。高收入国家的生存率约为90%，而在低收入国家，这一比例低于50%。本研究评估了肯尼亚一家学术医院肾母细胞瘤患者的治疗结果。
我们对2010年至2012年间所有诊断为肾母细胞瘤的儿童进行了回顾性病历审查。收集了治疗结果以及各种社会人口统计学和临床特征的数据。
在39例肾母细胞瘤患者中，41%的患者无事件生存，31%的患者放弃治疗，23%的患者死亡，5%的患者疾病进展或复发。大多数患者就诊时处于晚期：I期（0%）、II期（7%）、III期（43%）、IV期（40%）或V期（10%）。低分期（I至III期）疾病患者最可能的治疗结果是无事件生存（67%），而高分期（IV至V期）疾病患者最可能的治疗结果是死亡（40%）。低分期疾病患者中未记录到死亡或疾病进展或复发的情况；他们治疗失败的唯一原因是放弃治疗。疾病分期显著影响治疗结果（P = 0.014）和无事件生存估计（P < 0.001）。诊断时的年龄、性别、症状持续时间、到医院的距离和健康保险状况对治疗结果或无事件生存估计没有统计学上的显著影响。
肯尼亚肾母细胞瘤患者的生存率低于高收入国家。放弃治疗是治疗失败最常见的原因。诊断时的疾病分期在统计学上显著影响治疗结果和生存率。
