Current Realities of Wilms Tumor Burden and Therapy in Ghana

dc.contributor.authorKontchou, N-A.T.
dc.contributor.authorAmankwah, E.
dc.contributor.authorSeidu, I.
dc.contributor.authoret al.
dc.date.accessioned2024-05-29T15:26:58Z
dc.date.available2024-05-29T15:26:58Z
dc.date.issued2024
dc.descriptionResearch Articleen_US
dc.description.abstractBackground: Between 2005 and 2014, Ghana's Wilms tumor (WT) 2-year disease-free survival of 44% trailed behind that of high-income countries. This study aimed to uncover social determinants of health leading to preventable WT death in Ghana. Methods: WT patient records (2014e2022) at Korle-Bu Teaching Hospital (KBTH; Ghana) were reviewed retrospectively. Demographics, clinical course, tumor characteristics, and survival were evaluated using t-tests, Pearson Chi-square, and multivariate Cox logistic regression. Results: Of 127 patients identified, 65 were female. Median age was 44 months [IQR 25e66]. Forty-eight patients (38%) presented with distant metastasis (75% lung, 25% liver), which associated with hypo albuminemia (p ¼ 0.009), caregiver informal employment (p ¼ 0.04), and larger tumors (p ¼ 0.002). Despite neoadjuvant chemotherapy shrinking 84% of tumors, larger initial size associated with incom plete resection (p ¼ 0.046). Of 110 nephrectomies, 31 patients had residual disease, negatively impacting survival (p ¼ 2.7 10 5 ). Twenty-two patients (17%) abandoned treatment (45% before nephrectomy; 55% after nephrectomy), with seven patients ultimately lost to follow-up (LTFU). Decedents represented 43% of stage IV patients compared to 28% in other stages. Event-free survival (EFS) was 60% at 4 years with overall survival (OS) at 67%. Conclusions: Although Ghana's WT survival has improved, informal employment and distance from KBTH predisposed patients to delayed referral, greater tumor burden, hypoalbuminemia, and lower survival. Type of Study: Prognosis Study. Level of Evidence: IIen_US
dc.identifier.citationontchou N-AT et al., Current Realities of Wilms Tumor Burden and Therapy in Ghana, Journal of Pediatric Surgery, https://doi.org/10.1016/j.jpedsurg.2024.03.032en_US
dc.identifier.otherhttps://doi.org/10.1016/j.jpedsurg.2024.03.032
dc.identifier.urihttp://ugspace.ug.edu.gh:8080/handle/123456789/42056
dc.language.isoenen_US
dc.publisherJournal of Pediatric Surgeryen_US
dc.subjectWilms tumoren_US
dc.subjectSocial determinants of healthen_US
dc.subjectSurvivalen_US
dc.titleCurrent Realities of Wilms Tumor Burden and Therapy in Ghanaen_US
dc.typeArticleen_US

Files

Original bundle

Now showing 1 - 1 of 1
Thumbnail Image
Name:
Current Realities of Wilms Tumor Burden and Therapy in Ghana.pdf
Size:
827.88 KB
Format:
Adobe Portable Document Format
Description:

License bundle

Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description: