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CC BY-NC-ND 4.0 · South Asian J Cancer
DOI: 10.1055/s-0044-1790223
Original Article

Clinical Profile and Outcomes of Childhood Wilms Tumors Treated in a Tertiary Cancer Center from North India

Soumitra Saha 
1   Division of Paediatric Surgical Oncology, Department of Surgical Oncology, Homi Bhabha Cancer Hospital, Tata Memorial Center, Homi Bhabha National Institute Varanasi, Uttar Pradesh, India
,
Shyam Srinivasan 
2   Division of Pediatric Oncology, Tata Memorial Hospital & ACTREC, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Sambit Swarup Nanda
3   Department of Radiation Oncology, Homi Bhabha Cancer Hospital, Tata Memorial Center, Homi Bhabha National Institute Varanasi, Uttar Pradesh, India
,
Zachairah Chowdhury
4   Department of Oncopathology, Homi Bhabha Cancer Hospital, Tata Memorial Center, Homi Bhabha National Institute Varanasi, Uttar Pradesh, India
,
Raghwesh Ranjan
5   Division of Pediatric Oncology, Department of Medical Oncology, Homi Bhabha Cancer Hospital, Tata Memorial Center, Homi Bhabha National Institute Varanasi, Uttar Pradesh, India
,
Ankita Pal 
6   Department of Bio-Statistics, Homi Bhabha Cancer Hospital, Tata Memorial Center, Homi Bhabha National Institute Varanasi, Uttar Pradesh, India
,
Pooja Pande
7   Department of Radiodiagnosis, Homi Bhabha Cancer Hospital, Tata Memorial Center, Homi Bhabha National Institute Varanasi, Uttar Pradesh, India
,
Ashutosh Mukherji
3   Department of Radiation Oncology, Homi Bhabha Cancer Hospital, Tata Memorial Center, Homi Bhabha National Institute Varanasi, Uttar Pradesh, India
,
Vikramjit Singh Kanwar
5   Division of Pediatric Oncology, Department of Medical Oncology, Homi Bhabha Cancer Hospital, Tata Memorial Center, Homi Bhabha National Institute Varanasi, Uttar Pradesh, India
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Abstract

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Soumitra Saha

In India and other lower-middle-income countries, the progress in the management of Wilms tumor (WT) has lagged behind when compared to the developed countries. In the current study, we highlight the outcomes of 61 children with WT treated at an oncological center in northern India. Our study found that the patient demographics, including age and gender distribution, closely paralleled other Indian studies. Notably, 24% of patients had distant metastasis at diagnosis. An upfront biopsy was performed in majority of the patient with a remarkable concordance rate of over 90%, with no significant complications associated with the procedure. Our surgical approach, guided by image-defined risk factors, resulted in 84% of patients undergoing delayed surgery after chemotherapy. Notably, the incidence of intraoperative complications, including tumor spill, was minimal. Treatment abandonment and toxic death due to sepsis emerged as significant challenges, affecting 22% and 7% of our patient cohort, respectively. The 3-year event-free survival (EFS) and overall survival were 70% and 84%, respectively. The age group of 6 to 8 years and stage V disease emerged as adverse factors influencing EFS. In summary, our study highlights the multifaceted nature of WT management in resource-constrained settings with survival rates promising but still lagging behind high-income countries. Addressing challenges such as treatment abandonment and reducing toxic death is imperative to enhance outcomes of WT in India.

Keywords

chemotherapy - India - lower-middle-income countries - nephrectomy - toxicity - Wilms tumor


Publication History

Received: 21 September 2023

Accepted: 29 July 2024

Article published online:
03 September 2024

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