Wilms' tumour: presentation and treatment

ABSTRACT

To determine the clinical presentation and treatment results of patients of Wilms tumour treated with United Kingdom Children's Cancer Study Group [UKCCSG] protocol. Design: An interventional study. Place and Duration of Study The study was conducted in the Paediatric Oncology Department of Combined Military Hospital, Rawalpindi [CMH RWP], from January 1999 to December 2000. Subject and All patients of Wilms' tumour managed by using UKCCSG treatment protocol were included in the study. The patients were thoroughly investigated before treatment. Surgery, chemotherapy and radiotherapy were performed as per protocol. Twenty-two patients including 13 boys and 09 girls with the mean age of 28 months, ranging from 4 months to 7 years were studied. The tumour involved right kidney in 13 and left in 9 patients. Two [09%] patients had stage I, 5 [23%] stage II, 11 [50%] stage III and 04 [18%] stage IV disease. Histology was favourable in 18 and unfavourable in 04 patients. Nineteen [86.4%] patients underwent primary surgery, one had delayed surgery while 02 [9%] patients had inoperable tumour and died despite chemotherapy. Three patients died during maintenance chemotherapy and one after completion of treatment. The overall mortality was 06 [27.3%]. Three patients were lost to follow-up. The treatment outcome is comparable to UKCCSG results. Challenges to be addressed in our set up include illiteracy, deficiency of resources, and regularity of treatment and follow-up. system and, therefore, its application is recommended to evaluate ovarian masses in clinical practice