Clinicopathological Features, Management and Outcome of Paediatric Solid Renal Tumours in Southeast Nigeria: The Need for Protocol and Multidisciplinary Collaboration
Introduction: Renal malignancies are common in children and they constitute 6-7% of all childhood tumours and nephroblastoma is the most common solid renal tumour in children. Currently, standardised institutional protocols in management of renal tumours in children are the norm. Large scale co...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-04-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/14775/46506_CE[Ra1]_F[SK]_PF1(AKA_SL)_PFA(KM)_PN(KM).pdf |
| Summary: | Introduction: Renal malignancies are common in children
and they constitute 6-7% of all childhood tumours and
nephroblastoma is the most common solid renal tumour in
children. Currently, standardised institutional protocols in
management of renal tumours in children are the norm. Large
scale collaborative studies have started emerging, yet not much
has been documented on the clinical presentation, pathology
and outcome of solid renal tumours particularly in Africa.
Aim: To review the presentations, pathology and the
management-outcome of solid renal tumour in the centre in
the absence of a coordinated protocol and multi disciplinary
collaboration.
Materials and Methods: This was a nine and a half year
longitudinal retrospective audit study of consecutive patients
with solid renal tumours managed in a single tertiary centre:
Nnamdi Azikiwe University Teaching Hospital, Nnewi, Southeast Nigeria. It took place from January 2009-June 2018.
Relevant data on demography, clinical features, management
and outcome were extracted from records. Results were
analysed using Statistical Package for Social Sciences (SPSS)
version 22. Categorical data were tested for independence
using Chi-square test and significant p-value set at <0.05.
Results: Twenty two paediatric cases (15 males and 7 females)
were included in the study. The mean age at presentation was
50.10±45.18 months. The mean duration of symptoms was 5.5
months; 21 (95.5%) presented with abdominal masses while 6
(27.3%) had gross haematuria and 13 (59.1%) were emaciated.
Tumours involved left kidney in 15 (68%). Histological reports
were available in 9 cases with nephroblastoma being the most
common 6 (27.3%). The most common stage was stage 3, 10
(45.5%) and most common procedure was nephroureterectomy,
11 (50%). Neo-adjuvant and adjuvant therapies were
inconsistent.
Conclusion: Late presentation, discordant treatment protocol,
non completion of treatment and poor collaboration, were found
to contribute largely to poor outcome of solid renal tumours
in children in our setting. It is strongly believed that adoption
of standard protocol and a multidisciplinary collaboration in
management will improve records keeping and outcome. |
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| ISSN: | 2249-782X 0973-709X |