Wilms' Tumor: Survival Analysis in Children Under 15 Treated at a Pediatric Oncology Unit of a Cancer Treatment Institution

Tumor de Wilms: análisis de supervivencia en niños menores de 15 años tratados en una unidad de oncología pediátrica de una institución para el tratamiento de cáncer

At the National Institute of Cancerology (INC) in Colombia, the treatment of Wilms' tumor (WT) follows strategies from the National Wilms Tumor Study Group (NWTSG I to V). Objective: to describe the clinical characteristics, overall survival (OS) and event-free survival (EFS) of children under 15 years of age with WT, treated with a protocol based on NWTSG guidelines between 2008 and 2018. Methods: a retrospective observational study of a cohort of children under 15 years of age with a diagnosis of WT, treated according to NWTSG guidelines at the INC between January 1, 2008, and December 31, 2018. A descriptive analysis of demographic and clinical variables was performed. EFS and OS were calculated using the Kaplan-Meier method. Results: we identified 48 patients with a diagnosis of WT; the mean age was 3.95 years (±2.27), with a male-to-female ratio of 1.18. The majority (58%) presented with advanced-stage disease (III and IV). Unfavorable histology was observed in 16.7%, with a relapse rate of 31% and a mortality rate of 21%. The EFS and OS rates were 62% and 77.3%, respectively, at 10.4 years; the most common cause of mortality was relapse. Conclusion: at INC, most children with WT present with advanced-stage disease. Although survival rates achieved with multidisciplinary treatment are lower in middle-income countries compared to high-income countries, they are reasonably acceptable. Enhanced diagnostic testing is necessary to develop more precisely risk-adapted treatments.