Factors Associated with Survival in Wilms Tumor Patients

Abstract

Introduction: Wilms tumor is the second most common abdominal tumor in the pediatric age group and accounts for more than 90% of renal tumors in pediatrics. Even though the described survival rate is greater than 90%, we found that it only reaches 70% among our patients. Therefore, we aim to evaluate which are the factors associated with these unfavorable results, in order to implement measures to improve the survival of our patients. Methods: An observational, cross-sectional study was conducted in two high-level care centers, which included a sample of 84 patients under 15 years of age, diagnosed with Wilms tumor. Results: Factors significantly associated with an increased likelihood of death were failure to complete the chemotherapy protocol (odds ratio [OR] = 34; 95% confidence interval [CI] = 3.7–312; P = 0.000) and tumor recurrence (OR = 35.7; 95% CI = 6.9–184; P = 0.000). Other minor factors with certain impact were bilateral presentation (OR = 4.1; 95% CI = 0.6–5.5; P = 0.147), surgical complications (OR = 3.2; 95% CI = 0.7–14.6; P = 0.136), lymph node involvement on CT scan (OR 2.4; 95% CI 0.7­–8.4; P = 0.139), and distant metastases (OR = 2.5; 95%CI = 0.7–9; P = 0.143). Discussion: The survival of our patients with Wilms tumor is lower than that reported in literature is associated with factors like failure to complete chemotherapy, recurrence, and the need for bilateral surgery.