Wilms tumour experience in a South African centre.
BACKGROUND
In Africa, Wilms tumour frequently presents with advanced disease. This study reports our results over 25 years using the National Wilms Tumour Study Group (NWTSG) approach of primary surgery followed by chemotherapy.


METHODS
A retrospective analysis was performed on all patients diagnosed with unilateral Wilms tumour between January 1979 and December 2003.


RESULTS
The records of 188 children with newly diagnosed Wilms tumour were examined. Of these 57 (30.3%) were stage I, 33 (17.6%) were stage II, 60 (31.9%) were stage III and 38 (20.2%) were stage IV. Twenty-four patients (12.8%) had unfavourable histology (UFH). The estimated 5-year overall survival (OS) for the whole group was 80.5% (84.8% for favourable histology (FH) and 51.6% for UFH). Among those with FH, estimated 5-year OS was 94.4% for stage I, 96.2% for stage II, 84.9% for stage III and 54.2% for stage IV. There was no difference in OS between those FH stage III tumours that were operable and those deemed inoperable. Intra-operative spillage was uncommon (8%), and did not increase local relapse rate.


CONCLUSIONS
National Wilms Tumour Study Group protocols employed in an African setting with highly competent and experienced surgical care, produced results for non-metastatic FH Wilms tumour comparable to those of the NWTSG.
Davidson
Alan
A
Haematology-Oncology Service, Red Cross Children's Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.
Hartley
Patricia
P
Desai
Farieda
F
Daubenton
John
J
Rode
Heinz
H
Millar
Alastair
A
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009367:Neoplasm Staging; D012008:Recurrence; D012189:Retrospective Studies; D013019:South Africa; D015996:Survival Rate; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*