Experience and outcomes of Nephroblastoma in Johannesburg, 2004-2016

Abstract

Background: Patients with nephroblastoma in low- and middle-income countries historically presented with advanced disease and poor outcomes, as is shown in previous South African studies. This study is to report our institution’s contemporary results as compared to the past with advances in disease management.

Methods: Retrospective review of the clinical records of patients 16 years and younger diagnosed with nephroblastoma and undergoing multidisciplinary management between 01 January 2004 and 31 December 2016 at the two teaching hospitals affiliated to University of the Witwatersrand.

Results: Two hundred and sixty-five patients were identified of which 47 were excluded leaving a total study cohort of 218 patients. The stage distribution was: stage I – 69 (31.7%), stage II – 33 (15.1%), stage III – 36 (16.5%), stage IV – 65 (29.8%), stage 5 – 15 (6.9%). The five-year overall survival was 85.4% and for each of the stages was as follows: stage I – 96.4%, stage II – 92.3%, stage III – 79.3%, stage IV – 72.2%, stage V – 92.9%.

Conclusion: The survival outcomes of this cohort improved compared to our previously reported series, and are now comparable to outcomes from institutions in high-income countries. In our previous series (1998-2003), the 4-year overall survival was 76%, stage I and II combined 89%, and stage III, IV, V combined were 66.75%. Early recognition and diagnosis contributes to a more favourable outcome and over the years these improvements have in turn lead to an improvement in the outcomes of our patients.