Hope and Challenges in the diagnosis and treatment of Wilms Tumor: a single-center retrospective study in China

Kongkong Cui ^1* Peng Hong ² Jie Lin ³ Zaihong Hu ⁴ Zhiqiang Gao ³ Xiao-Mao Tian ² Tao Lin ¹ Qinlin Shi ^2* Guanghui Wei ³

• ¹ Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing, China
• ² National Clinical Research Center for Child Health and Disorders, Chongqing, China
• ³ Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
• ⁴ Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, chongqing, China

Background: Wilms tumor (WT), which represents about 90% of kidney tumors in children, is the most prevalent type of renal tumor among children. In developed countries, advancements in treatments such as chemotherapy and radiotherapy have led to high survival rates. However, developing countries face significant challenges, including late-stage diagnosis, metastasis at presentation, and high rates of treatment abandonment.: This retrospective study included all patients diagnosed with WT at a tertiary hospital in Western China from 2007 to 2021. It involved the collection of sociodemographic and clinical details, including data on patients who abandoned treatment. Follow-up continued until July 2024.Result: Our study comprised 301 patients. Of the 259 who completed the treatment, the five-year event-free survival (EFS) and overall survival (OS) rates were 77.9% and 81.2%. Of the 42 patients who abandoned treatment, 13 refused further care immediately after diagnosis and signed a refusal document, 16 discontinued treatments during preoperative neoadjuvant chemotherapy, and 13 failed to complete the prescribed chemotherapy or radiotherapy.In our hospital, WT patient survival rates match those in developed countries.Challenges include late diagnosis and initial metastasis, making pediatric screenings essential.Addressing treatment abandonment and offering safer options for low-risk patients is key. For highrisk cases, oncologists need more effective strategies to improve outcomes.Wilms tumor (WT), which represents about 90% of kidney tumors in children, is the most prevalent type of renal tumor among children(1). Treatment typically involves a combination of chemotherapy, surgery, and, in certain cases, radiotherapy. Two main treatment strategies are used globally. The approach practiced by the Children's Oncology Group (COG) in North America involves upfront