Patterns of presentation, clinicopathological characteristics, management and outcomes of Wilms tumour in Ghana: A cross-sectional study

Introduction: Wilms tumor (WT) is the most common renal malignancy in children, with a peak incidence between the ages of 3 and 4 years. This study aimed to evaluate the clinicopathological features, treatment characteristics and survival outcomes of patients managed for WT at the study site. Methods: This was a quantitative cross-sectional study involving 137 pediatric patients diagnosed with and managed for WT between 2012 and 2021. Total population sampling was used for participant selection. Data were analyzed using SPSS software, with Kaplan-Meier and Cox regression analysis used to estimate survival rates and examine prognostic factors. P-values < 0·05 were considered statistically significant. Results: The 2- and 5-year overall survival (OS) rates were 75% and 70%, respectively, while the disease-free survival (DFS) rates at 2- and 5-years were both 79%. Pathological staging significantly impacted OS and DFS (p = 0·000), while age, gender, weight and risk stratification did not show statistically significant differences. The left kidney was the most common primary site (51%), with an even male to female gender ratio of 1:1. Metastases were most common in the chest (n = 19, 13·8%) and lungs (n = 13, 9·5%). Conclusions: Pathological stage was the most significant prognostic factor for both OS and DFS, emphasizing the importance of early detection and timely intervention. While the 2- and 5-year OS and DFS rates represent an improvement over previous studies in Ghana, they remain suboptimal compared to outcomes in high-income countries. A holistic, coordinated institutional treatment regimen has enhanced patient compliance, survival outcomes and follow-up care.