Current Realities of Wilms Tumor Burden and Therapy in Ghana
dc.contributor.author | Kontchou, N-A.T. | |
dc.contributor.author | Amankwah, E. | |
dc.contributor.author | Seidu, I. | |
dc.contributor.author | et al. | |
dc.date.accessioned | 2024-05-29T15:26:58Z | |
dc.date.available | 2024-05-29T15:26:58Z | |
dc.date.issued | 2024 | |
dc.description | Research Article | en_US |
dc.description.abstract | Background: 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: II | en_US |
dc.identifier.citation | ontchou 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.2024.03.032 | en_US |
dc.identifier.other | https://doi.org/10.1016/j.jpedsurg.2024.03.032 | |
dc.identifier.uri | http://ugspace.ug.edu.gh:8080/handle/123456789/42056 | |
dc.language.iso | en | en_US |
dc.publisher | Journal of Pediatric Surgery | en_US |
dc.subject | Wilms tumor | en_US |
dc.subject | Social determinants of health | en_US |
dc.subject | Survival | en_US |
dc.title | Current Realities of Wilms Tumor Burden and Therapy in Ghana | en_US |
dc.type | Article | en_US |
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