Treatment of Wilms tumor according to SIOP 9 protocol in Casablanca, Morocco.
BACKGROUND
Childhood Wilms tumor represents one of the challenge for pediatric oncologists in developing countries. We report the characteristics and treatment results of patients with Wilms tumor according to SIOP 9 protocol in Morocco.


METHODS
From January 1989 to December 2000, 86 children with Wilms tumor were admitted. The diagnosis was based on physical exam and abdominal ultrasound. The metastatic work-up was based on abdominal ultrasound and chest X-ray.


RESULTS
The mean age was 36 months (3-120 months). The sex-ratio was 1. Abdominal mass was the main symptom at presentation (84 cases). There were 13 metastatic cases. Treatment applied was according to SIOP 9 Protocol without randomization. Local deases was present in 75 patients with stage I in 38 cases (50%), IIN0 in 4 cases (6%), IIN1 in 9 cases, and III in 24 cases (44%). The distribution of pathologic groups was: favorable in 4 cases, standard in 69 cases, and unfavorable anaplastic type in 2 cases. Sixty-nine patients were evaluable for therapeutic evaluation. Other patients were lost to follow-up. Three patients died of treatment related toxicity and 13 patients relapsed. With a median follow-up of 70 months, the 5-year EFS and 5 years overall survival for evaluable patients are 77.4% and 79%, respectively while the 5-year EFS for all patients was 56%.


CONCLUSIONS
These results are encouraging for a developing country but special efforts should be done to reduce the rate of abandonment.
Madani
Abdellah
A
Hematology and Pediatric Oncology Department, Hôpital du 20 Août, Casablanca, Morocco. abdellah_md@yahoo.fr
Zafad
Saadia
S
Harif
M'hamed
M
Yaakoubi
Mohammed
M
Zamiati
Soumaya
S
Sahraoui
Souha
S
Benjelloun
Amal
A
Fehri
Mohammed
M
Benchekroun
Said
S
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009018:Morocco; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*