title: Wilms' tumour: Determinants of prognosis in an African setting.
abstract: BACKGROUND
  The few studies available in the literature on Wilms' tumour (WT) from sub-Saharan Africa have reported a dismal outcome for children with the tumour. This study evaluated the risk factors that have been correlated with outcome in the literature and compare these with outcome among our patients.
  
  
  METHODS
  Cases of histologically confirmed WT between 2009 and 2013 in a tertiary hospital in Northwestern Nigeria were evaluated for gender, age, laterality, symptoms, duration before presentation, stage at presentation, histologic subtype and p53 mutation. These were then correlated with outcome.
  
  
  RESULTS
  Totally, 30 cases of WT were diagnosed with mean age of 4.8 ± 1.9 years; and male:female ratio of 2:1. No statistically significant relationship with outcome was found for gender (P = 0.138) or histologic subtype (P = 0.671). The most significant variables which positively influenced the outcome were presentation at earlier stages (P = 0.007) and completion of therapy (P = 0.0007). p53 mutation was seen in 3 (16.7%) of 18 cases and was not associated with a poor outcome (P = 0.089). However, 2 of the 3 cases presented in Stage IV and none of them survived the 1 st year.
  
  
  CONCLUSIONS
  This study shows that even though p53 mutation was associated with a more aggressive phenotype, the most significant determinants of a good outcome among patients in a developing country like ours is non-blastemal dominant histologic subtype, early stage at presentation and completion of therapy.
authors.affiliation: Department of Pathology, Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria.
authors.forename: Akinfenwa Taoheed
authors.initials: AT
authors.lastname: Atanda
authors.forename: Lofty-John Chuhwuemeka
authors.initials: LJ
authors.lastname: Anyanwu
authors.forename: Oladoyin Jareenat
authors.initials: OJ
authors.lastname: Atanda
authors.forename: Aminu Mohammad
authors.initials: AM
authors.lastname: Mohammad
authors.forename: Lawal Barau
authors.initials: LB
authors.lastname: Abdullahi
authors.forename: Aliyu Umar
authors.initials: AU
authors.lastname: Farinyaro
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D009017:Morbidity / Q000639:trends; D009392:Nephrectomy / Q000379:methods*; D009549:Nigeria / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery