Clinical presentation and treatment outcome in children with nephroblastoma in Kenya.
OBJECTIVE
To review the clinical presentation and management of children with nephroplastoma and the factors influencing the outcome at Kenyatta National Referral and Teaching Hospital (KNH).


METHODS
This was a retrospective case series study based on secondary data accumulated between 1990 and 1996.


METHODS
The relevant data were extracted from records of all children aged 12 years and below, admitted for cancer at KNH, Nairobi.


RESULTS
Out of 803 children with cancer, 71 (8.8%) had histologically proven nephroblastoma. At presentation, 1.5% were in stage I, 13.2% stage II, 36.8% stage III, 41.2% stage IV and 7.4% stage V. Eighty five per cent presented with stage III-V disease. Ninety five per cent had nepherectomy and received chemotherapy. Radiotherapy was given to 50.7% of the patients. Nine patients died before commencement of chemotherapy, two of whom died in the immediate post-operative period. The median duration between admission and surgery was 41 days. Pre-operative chemotherapy was given to 42% of the patients. Approximately 25.5% of the patients received little or no induction chemotherapy due to unavailability of drugs while only 2.8% received the prescribed maintenance treatment with the remainder getting erratic or no treatment. Overall, only 34.7% remained disease free two years from time of diagnosis.


CONCLUSIONS
Late presentation, poor availability of cytotoxic drugs and frequent treatment interruptions for various reasons have contributed to the poor outcome of nephroblastoma in Kenya.
Abdallah
F K
FK
Department of Haematology and Blood Transfusion, College of Health Sciences, University of Nairobi, P.O. Box 19676, Nairobi, Kenya.
Macharia
W M
WM
D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D012074:Remission Induction; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*