Wilms tumor in Africa: A systematic review of management challenges and outcome in two decades (2000-2019)

Pediatr Blood Cancer. 2020 Nov;67(11):e28695. doi: 10.1002/pbc.28695. Epub 2020 Sep 10.

Abstract

We performed a systematic review to highlight trends in management and outcome of Wilms tumor (WT) in Africa in the past two decades (2000-2019). Twenty-seven studies involving 2250 patients were analyzed. Overall, barring regional variations, 57.7% of the cases presented with advanced disease, 57.3% completed planned treatment, and survival was 56.5%. The publications in the two decades did not show significant differences in proportions of cases with advanced disease, completion of treatment rate, and cases lost to follow up. However, significantly more cases received preoperative chemotherapy, and survival improved in the last decade (2010-2019) compared to the earlier decade (2000-2009). Survival of WT in Africa might have improved in the last decade, but challenges of delayed presentation and abandonment of treatment have persisted. Measures that will encourage early access to expert care as well as improve on treatment compliance may further improve survival of WT in Africa.

Keywords: Africa; Wilms tumor; challenges; developing countries; meta-analysis; outcome.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Africa / epidemiology
  • Combined Modality Therapy
  • Humans
  • Kidney Neoplasms / epidemiology
  • Kidney Neoplasms / mortality*
  • Kidney Neoplasms / therapy*
  • Patient Compliance / statistics & numerical data*
  • Wilms Tumor / epidemiology
  • Wilms Tumor / mortality*
  • Wilms Tumor / therapy*