Wilms’ tumor in low- and middle-income countries: survey of current practices, challenges, and priorities
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 Wilms’ tumor surgical strategy in LMIC. This survey was di...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-05-01
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| Series: | Annals of Pediatric Surgery |
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| Online Access: | https://doi.org/10.1186/s43159-022-00163-6 |
| _version_ | 1818195694584856576 |
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| author | Megan Thuy Vu Jaime Shalkow Bindi Naik-Mathuria Sajid S. Qureshi Doruk Ozgediz Kokila Lakhoo Hafeez Abdelhafeez On behalf of the Pan African Paediatric Surgery Association (PAPSA) and Global Initiative for Children’s Surgery (GICS) initiative |
| author_facet | Megan Thuy Vu Jaime Shalkow Bindi Naik-Mathuria Sajid S. Qureshi Doruk Ozgediz Kokila Lakhoo Hafeez Abdelhafeez On behalf of the Pan African Paediatric Surgery Association (PAPSA) and Global Initiative for Children’s Surgery (GICS) initiative |
| author_sort | Megan Thuy Vu |
| collection | DOAJ |
| description | 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 Wilms’ tumor surgical strategy in LMIC. 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. |
| first_indexed | 2024-12-12T01:22:16Z |
| format | Article |
| id | doaj.art-a6156f297ce94b53911ff8ee238bdd5c |
| institution | Directory Open Access Journal |
| issn | 2090-5394 |
| language | English |
| last_indexed | 2024-12-12T01:22:16Z |
| publishDate | 2022-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Pediatric Surgery |
| spelling | doaj.art-a6156f297ce94b53911ff8ee238bdd5c2022-12-22T00:43:12ZengSpringerOpenAnnals of Pediatric Surgery2090-53942022-05-011811810.1186/s43159-022-00163-6Wilms’ tumor in low- and middle-income countries: survey of current practices, challenges, and prioritiesMegan Thuy Vu0Jaime Shalkow1Bindi Naik-Mathuria2Sajid S. Qureshi3Doruk Ozgediz4Kokila Lakhoo5Hafeez Abdelhafeez6On behalf of the Pan African Paediatric Surgery Association (PAPSA) and Global Initiative for Children’s Surgery (GICS) initiativeMichael E. DeBakey Department of Surgery, Baylor College of MedicineDepartment of Surgical Oncology, National Institute of Pediatrics and ABC Cancer Center, Anahuac UniversityDivision of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine and Texas Children’s HospitalDivision of Pediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial CentreDepartment of Surgery, University of California San FranciscoDepartment of Paediatric Surgery, University of Oxford and Oxford University Hospitals NHS TrustDepartment of Surgery, St. Jude Children’s Research HospitalAbstract 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 Wilms’ tumor surgical strategy in LMIC. 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.https://doi.org/10.1186/s43159-022-00163-6Wilms’ tumorNephroblastomaPediatricsOncologyGlobal surgery |
| spellingShingle | Megan Thuy Vu Jaime Shalkow Bindi Naik-Mathuria Sajid S. Qureshi Doruk Ozgediz Kokila Lakhoo Hafeez Abdelhafeez On behalf of the Pan African Paediatric Surgery Association (PAPSA) and Global Initiative for Children’s Surgery (GICS) initiative Wilms’ tumor in low- and middle-income countries: survey of current practices, challenges, and priorities Annals of Pediatric Surgery Wilms’ tumor Nephroblastoma Pediatrics Oncology Global surgery |
| title | Wilms’ tumor in low- and middle-income countries: survey of current practices, challenges, and priorities |
| title_full | Wilms’ tumor in low- and middle-income countries: survey of current practices, challenges, and priorities |
| title_fullStr | Wilms’ tumor in low- and middle-income countries: survey of current practices, challenges, and priorities |
| title_full_unstemmed | Wilms’ tumor in low- and middle-income countries: survey of current practices, challenges, and priorities |
| title_short | Wilms’ tumor in low- and middle-income countries: survey of current practices, challenges, and priorities |
| title_sort | wilms tumor in low and middle income countries survey of current practices challenges and priorities |
| topic | Wilms’ tumor Nephroblastoma Pediatrics Oncology Global surgery |
| url | https://doi.org/10.1186/s43159-022-00163-6 |
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