title: Nephroblastoma--a 25-year review of a South African unit.
abstract: BACKGROUND
  To determine the outcome of patients with nephroblastoma in a South African hospital.
  
  
  OBJECTIVE
  To determine if there is a difference in the outcome of patients with nephroblastoma comparing two treatment protocols SIOP (Société International D'Oncologie Pédiatrique Protocol) versus NWTS (National Wilms' Tumour Study Protocol).
  
  
  RESULTS
  A retrospective audit of 25 years (1983-2007), of children diagnosed with nephroblastoma in Tygerberg Hospital. One hundred and seven patients were included in the study and 98 were analyzed. The average age at diagnosis was 3.8 years. Most patients (37%) presented with stage 1 of the disease, followed by patients with stage 3 (27%). Most patients were treated according to the SIOP protocol (61%). Gender and race did not influence the outcome. Patients with stage 1 and 2 of the disease had the best outcome (76% versus 43% for stages 3 and 4). The SIOP group had a better outcome than the NWTS group (p value 0.001). The two groups had an equal distribution of the stage of presentation. The tumor volumes were bigger in the NWTS group (1004cm3 compared to 613cm3). Nutritional status did not influence the outcome although more patients were underweight for age in the SIOP group. The statistical methods used were: Kaplan Meier, Gehan's Wilcoxon Test, Chi -square test and the Fisher exact test.
  
  
  CONCLUSIONS
  Contrary to the other studies, patients treated according to the SIOP protocol had a statistically significant better outcome. Larger collaborative studies are needed to investigate this result in Africa.
authors.affiliation: Department of Paediatrics and Child Health, Stellenbosch University, Faculty of Health Sciences, Tygerberg Hospital.
authors.forename: Y T
authors.initials: YT
authors.lastname: Visser
authors.affiliation: Department of Paediatrics and Child Health, Stellenbosch University, Faculty of Health Sciences, Tygerberg Hospital.
authors.forename: R
authors.initials: R
authors.lastname: Uys
authors.affiliation: Department of Paediatrics and Child Health, Stellenbosch University, Faculty of Health Sciences, Tygerberg Hospital.
authors.forename: A
authors.initials: A
authors.lastname: van Zyl
authors.affiliation: Department of Paediatrics and Child Health, Stellenbosch University, Faculty of Health Sciences, Tygerberg Hospital.
authors.forename: D C
authors.initials: DC
authors.lastname: Stefan
mesh_terms: D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002675:Child, Preschool; D003609:Dactinomycin / Q000627:therapeutic use; D006801:Humans; D053208:Kaplan-Meier Estimate; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013019:South Africa; D018709:Statistics, Nonparametric; D014750:Vincristine / Q000627:therapeutic use; D009396:Wilms Tumor / Q000188:drug therapy* / Q000503:physiopathology*
chemical_list: D003609:Dactinomycin; D014750:Vincristine
keywords: NWTS = National Wilms’ Tumor Study Protocol; SIOP = Société International D’Oncologie Pédiatrique Protocol