Abstract
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.
Key words
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Article info
Publication history
Accepted:
March 8,
2013
Received:
February 15,
2013
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
