title: Treatment of Wilms tumor according to SIOP 9 protocol in Casablanca, Morocco.
abstract: 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.
authors: Hematology and Pediatric Oncology Department, Hôpital du 20 Août, Casablanca, Morocco. abdellah_md@yahoo.fr
authors: Abdellah
authors: A
authors: Madani
authors: Saadia
authors: S
authors: Zafad
authors: M'hamed
authors: M
authors: Harif
authors: Mohammed
authors: M
authors: Yaakoubi
authors: Soumaya
authors: S
authors: Zamiati
authors: Souha
authors: S
authors: Sahraoui
authors: Amal
authors: A
authors: Benjelloun
authors: Mohammed
authors: M
authors: Fehri
authors: Said
authors: S
authors: Benchekroun
mesh_terms: 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*