Surgical aspects and outcomes after nephrectomy for Wilms tumour in sub‐Saharan Africa: A report from Wilms Africa Phase II—CANCaRe Africa

• Published in: Pediatric blood & cancer 2025-01, Vol.72 (1), p.e31134-n/a
• Main Authors: Appeadu‐Mensah, William, Mdoka, Cecilia, Alemu, Seifu, Yifieyeh, Abiboye, Kaplamula, Tiya, Oyania, Felix, Chagaluka, George, Mulugeta, Gersam Abera, Kudowa, Evaristar, Yimer, Mulugeta, Renner, Lorna Awo, Paintsil, Vivian, Chitsike, Inam, Molyneux, Elizabeth, Atwiine, Barnabas, Kouya, Francine, Pritchard‐Jones, Kathy, Abdelhafeez, Hafeez, Dessalegne, Andient, Mbuwayesango, Bothwell, Georges, Ngock, Israels, Trijn, Borgstein, Eric
• Format: Article
• Language: English
• Subjects: Adolescent; Africa; Africa South of the Sahara - epidemiology; Chemotherapy; Child; Child, Preschool; Children; Female; Follow-Up Studies; Humans; Infant; Kidney Neoplasms - mortality; Kidney Neoplasms - pathology; Kidney Neoplasms - surgery; Lymph nodes; Male; Metastases; Nephrectomy; nephroblastoma; Patients; Prognosis; Prospective Studies; Radiation therapy; resource‐limited settings; Rupture; Surgery; Surgical outcomes; Survival; Survival Rate; Tumors; Wilms; Wilms Tumor - mortality; Wilms Tumor - pathology; Wilms Tumor - surgery
• ISSN: 1545-5009; 1545-5017; 1545-5017
• DOI: 10.1002/pbc.31134

Background Wilms tumour (WT) is one of the common and curable cancer types targeted by the Global Initiative for Childhood Cancer. Tumour excision is essential for cure. This analysis focuses on surgical outcomes of patients with WT in sub‐Saharan Africa. Methods We implemented a risk‐stratified WT treatment guideline as a multicentre, prospective study across eight hospitals and six countries. Eligibility criteria were age 6 months to 16 years, unilateral WT, surgery performed after preoperative chemotherapy and diagnosed between 1 January 2021 and 31 December 2022. Data collection included a specific surgical case report form (CRF). Results The study registered 230 patients, among whom 164 (71.3%) had a nephrectomy. Ninety‐eight percent of patients had a completed surgical CRF. Out 164 patients, 50 (30.5%) had distant metastases. Median tumour diameter at surgery was 11.0 cm. Lymph node sampling was done in 122 (74.3%) patients, 34 (20.7%) had intraoperative tumour rupture, and for 18 (10.9%), tumour resection involved en bloc resection of another organ. Tumour size at surgery was significantly correlated with tumour rupture (p