Wilms’ tumor in low- and middle-income countries: survey of current practices, challenges, and priorities
Vu, M., Shalkow, J., Naik-Mathuria, B., Qureshi, S., Ozgediz, D., Lakhoo, K., Abdelhafeez, H. (2022). Wilms’ tumor in low- and middle-income countries: survey of current practices, challenges, and priorities. EKB Journal Management System, 18(1), -. doi: 10.1186/s43159-022-00163-6
Megan Thuy Vu; Jaime Shalkow; Bindi Naik-Mathuria; Sajid S. Qureshi; Doruk Ozgediz; Kokila Lakhoo; Hafeez Abdelhafeez. "Wilms’ tumor in low- and middle-income countries: survey of current practices, challenges, and priorities". EKB Journal Management System, 18, 1, 2022, -. doi: 10.1186/s43159-022-00163-6
Vu, M., Shalkow, J., Naik-Mathuria, B., Qureshi, S., Ozgediz, D., Lakhoo, K., Abdelhafeez, H. (2022). 'Wilms’ tumor in low- and middle-income countries: survey of current practices, challenges, and priorities', EKB Journal Management System, 18(1), pp. -. doi: 10.1186/s43159-022-00163-6
Vu, M., Shalkow, J., Naik-Mathuria, B., Qureshi, S., Ozgediz, D., Lakhoo, K., Abdelhafeez, H. Wilms’ tumor in low- and middle-income countries: survey of current practices, challenges, and priorities. EKB Journal Management System, 2022; 18(1): -. doi: 10.1186/s43159-022-00163-6

Wilms’ tumor in low- and middle-income countries: survey of current practices, challenges, and priorities

Annals of Pediatric Surgery
Volume 18, Issue 1, January 2022  XML PDF (1003.75 K)
DOI: 10.1186/s43159-022-00163-6
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Authors
Megan Thuy Vu email orcid ; Jaime Shalkow; Bindi Naik-Mathuria; Sajid S. Qureshi; Doruk Ozgediz; Kokila Lakhoo; Hafeez Abdelhafeez
Abstract
Purpose
To identify the current practices and priorities in Wilms’ tumor management for surgeons in low- and middle-income countries (LMICs).
Methods
One hundred thirty-seven pediatric surgeons from 44 countries completed surveys on ’ . This survey was distributed through the Global Initiative for Children’s Surgery, Pan-African Pediatric Surgical Association, and Latin American Pediatric Surgical Oncology Group.
Results
Ninety-two respondents (67.2%) participated from 19 lower middle-income countries (43.2%). Twenty-one respondents (15.3%) participated from nine lower income countries (20.5%). Nineteen respondents (13.9%) participated from 13 upper middle-income countries (29.5%). Most providers do not obtain biopsy for suspected Wilms’ tumor (79%). Delayed resection after preoperative chemotherapy is the preferred approach (70%), which providers chose due to protocol (45%), to decrease tumor rupture (22%), and to decrease complications (8%). The providers’ goal was to prevent tumor spillage and upstaging (46%) or to prevent bleeding, complication, or other organ resections (21%). Most surgeons believed that upfront resection increased the risk of tumor spillage (72%).
Conclusion
Providers in LMICs prefer delayed resection after preoperative chemotherapy to reduce the incidence of tumor spillage and upstaging of Wilms’ tumor. An evidence-based guideline tailored to the LMIC context can be developed from these findings.
Keywords
wilms’ tumor; Nephroblastoma; Pediatrics; Oncology; Global surgery
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