Wilms Tumor: 12 years’ experience in two high level hospitals in Medellín, Colombia

Abstract

Objective: To describe the epidemiology and results of Wilms Tumor management in children <15 years old in two quaternary are hospitals over a period of 12 years. Methods: A retrospective follow-up cohort study of the clinical records of patients diagnosed with WT between January 2005 and May 2017, focusing on collecting data on age, clinical presentation, histopathological confirmation and tumor classification, the type of treatment and follow-up outcome in terms of relapse and survival. Results: 84 patients diagnosed with WTs were found; their average age of presentation was 3 years old. Stage III prevailed at diagnosis and the main clinical presentation was abdominal mass. 8.3% patients had unfavorable histology. The average time of relapsefree survival was 97 months and at 108 months after diagnosis survival was 71%. Our hospitals, perform primary nephrectomy (COG / NWTS protocol). 39% of patients underwent neoadjuvant therapy, 72.7% were managed under the SIOP protocol and 27.3% under the COG / NWTS protocol. Conclusions: In the two hospitals analyzed, WTs is managed with the COG / NWTS protocol, using primary nephrectomy followed by chemotherapy. A group of patients undergoes preoperative chemotherapy following the American protocol. The diagnosis of our patients is more frequent in advanced stages. Survival in this series is 71 %, while the survival reported in the international literature is 93%.

Keywords

• Kidney Neoplasms; Nephrectomy; Wilms Tumor