Wilms tumor survival in Kenya.
Date
2013-06Author
Axt J.
Abdallah F.
Axt M.
Githanga Jessie N.
Hansen E.
Lessan J.
Li M.
Musimbi J.
Mwachiro M.
Newton M.
Ndung'u J.
Njuguna F.
Nzioka A.
Oruko O.
Patel K.
Tenge R.
Ukoli F.
White R.
O'Neill JA Jr.
Lovvorn HN 3rd.
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
PURPOSE:
Survival from Wilms Tumor (WT) exceeds 90% at 5 years in developed nations, whereas at last report, 2-year event-free survival (EFS) in Kenya reached only 35%. To clarify factors linked to these poor outcomes in Kenya, we established a comprehensive web-based WT registry, comprised of patients from the four primary hospitals treating childhood cancers.
MATERIALS AND METHODS:
WT patients diagnosed between January 2008 and January 2012 were identified. Files were abstracted for demographic characteristics, treatment regimens, and enrollment in the Kenyan National Hospital Insurance Fund (NHIF). Children under 15 years of age having both a primary kidney tumor on imaging and concordant histology consistent with WT were included.
RESULTS:
Two-year event-free survival (EFS) was 52.7% for all patients (n=133), although loss to follow up (LTFU) was 50%. For the 33 patients who completed all scheduled standard therapy, 2-year EFS was 94%. Patients enrolled in NHIF tended to complete more standard therapy and had a lower hazard of death (Cox 0.192, p < 0.001).
CONCLUSION:
Survival of Kenyan WT patients has increased slightly since last report. Notably, WT patients completing all phases of standard therapy experienced 2-year survival approaching the benchmarks of developed nations. Efforts in Kenya should be made to enhance compliance with WT treatment through NHIF enrollment.
URI
http://www.ncbi.nlm.nih.gov/pubmed/23845615http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/58294
Citation
J Pediatr Surg. 2013 Jun;48(6):1254-62Publisher
University of Nairobi School of Medicine
Collections
- Faculty of Health Sciences (FHS) [10377]