The management of wilms tumour in Kenya

Abstract

This paper presents results of a retrospective and a prospective study made from 1971-1974 and from (1975 - 1978) respectively on the management of nephroblastoma (Wilms' tumour) at the Kenyatta National Hospital (KNH) Nairobi, Kenya. The study was carried out to determine the prevalence, geographical distribution, age, sex pattern, mode of presentation, type of treatment , and survival rate. A total of 66 patients were treated in this period, the peak occurrence being in the O•4-year age-group. Most of the patients presented with advanced disease and both sexes were equally represented. A multimodal approach to the management of Wilms' tumour which consist¬ed of radical nephrectomy, postoperative irradiation of the tumour bed and chemotherapy was adhered to since 1975. Of all the patients 95% underwent surgery and resection of tumour was possible in 88% of them. Elective .chemotherapy was given to 73% of the patients and whenever possible radiation was given to the tumour bed. Patients in advanced stages of the disease did poorly and 45% of them died within one year after diagnosis. The main problems encountered included late presentation and difficulties of follow-up. Attempts are being made to establish diagnosis early and improve patient follow-up.