Predictors of treatment outcome of Wilms Tumour in low-income country; single centre experience from Pakistan

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

“…Current evidence indicates that this WT success is commonly associated with HICs where studies have shown a significant reduction of the barriers to WT management in the last century 1,2,34,35 . This contrasts nonetheless with the finding of poorer outcome in many low‐ and middle‐income countries (LMICs) in Africa 2,3,7–9,15,20–22 and outside of Africa 1,4,36–38 due to some persistent patient‐related, socioeconomic, and institutional factors.…”

“…WT is one of the major successes of pediatric oncology that has underscored the benefits of timely, intensive multimodality treatment, and strong supportive care 1,3,4,8,14,23,34 . Current evidence indicates that this WT success is commonly associated with HICs where studies have shown a significant reduction of the barriers to WT management in the last century 1,2,34,35 .…”

“…The improved survival has been attributed to early diagnosis; focused research; collaborative efforts among surgeons, pathologists, pediatricians, and radiation oncologists; and better supportive care 1–3 . Despite this great progress, there is evidence that survival in most low‐income countries (LICs) is substantially lower than that in the high‐income countries (HICs) 1,4 . Recent publications indicate that the overall survival in HICs approximates 90%, while survival in most LICs is less than 50% 1–5 .…”

“…Despite this great progress, there is evidence that survival in most low‐income countries (LICs) is substantially lower than that in the high‐income countries (HICs) 1,4 . Recent publications indicate that the overall survival in HICs approximates 90%, while survival in most LICs is less than 50% 1–5 . However, the statistic assumes a frightening dimension when considered against the backdrop of the finding that more than 80% of children with cancer worldwide live in LICs, where the situation is more difficult and the level of care considerably lower than the global benchmark 6 …”

“…Reported challenges that contribute to this disparity of outcome are late presentation (with most cases presenting with advanced disease), dearth of trained personnel, malnutrition, failure to complete treatment, and poorer facilities both for the specific cancer treatment and for supportive care 1,3,4,7 . In Africa, with heterogeneous economic, social, and cultural endowments, these challenges are not uniformly applicable in all the countries 2,3,7–13 .…”