Challenges and Opportunities of a Multi‐Institutional Treatment Guideline for Wilms Tumor in Low‐Middle‐Income Countries—A Report From the <i>Asociación de Hemato‐Oncología Pediátrica de Centro América</i> (AHOPCA)
Since 2000, centers across Central America have shared treatment guidelines for Wilms tumor, using histology (anaplasia present or absent) and tumor stage to stratify patients into low-, intermediate-, and high-risk groups. Weekly virtual tumor board meetings involving local and international experts were held to ensure consistent treatment assignments. We analyzed data from 367 children with unilateral tumors treated per these guidelines. Five-year abandonment-sensitive event-free and overall survival estimates were: low risk 82% ± 3.8% and 86% ± 3.6%, intermediate risk 50% ± 3.4% and 60% ± 3.4%, and high risk 36% ± 7.6% and 45% ± 7.9%. Survival outcomes were suboptimal, primarily due to advanced disease in fragile children at presentation and abandonment of treatment.
Authors
- Jessica Blanco (ORCID: https://orcid.org/0000-0002-2122-7138)
- Filippo Spreafico (ORCID: https://orcid.org/0000-0002-5587-3509)
- Monika L. Metzger (ORCID: https://orcid.org/0000-0002-7102-4611)
- Sandra Luna‐Fineman (ORCID: https://orcid.org/0000-0003-0713-7651)
- Soad Fuentes‐Alabi (ORCID: https://orcid.org/0000-0003-4245-3537)
- Thelma Velásquez (ORCID: https://orcid.org/0009-0004-8626-6244)
- Enrique Tome
- Roberta Ortiz (ORCID: https://orcid.org/0000-0002-8287-0928)
- Maria Grazia Valsecchi (ORCID: https://orcid.org/0000-0001-5574-3504)
- Patricia Valverde (ORCID: https://orcid.org/0000-0002-4519-1213)
- Juan M. González (ORCID: https://orcid.org/0000-0002-7301-8741)
- Valeria Colombo (ORCID: https://orcid.org/0000-0003-0097-8669)
- Magda Arreola
- Tamara González Gutiérrez
- Armando Peña
- L. J. Melendez
Institutions
- St. Jude Children's Research Hospital (US)
- World Health Organization Regional Office for the Americas (US)
- Children's Hospital Colorado (US)
- World Health Organization (CH)
- Center for Cancer and Blood Disorders (US)
- Hospital Nacional de Niños Bloom (SV)
- Hospital Infantil Manuel de Jesús Rivera (NI)
- Fondazione IRCCS Istituto Nazionale dei Tumori (IT)
- University of Colorado Anschutz Medical Campus (US)
- University of Milano-Bicocca (IT)
- University of Colorado Denver (US)
Publication Details
- Journal
- Pediatric Blood & Cancer
- Published
- 2025-02-20
- DOI
- https://doi.org/10.1002/pbc.31616
- Citations
- 1
- Primary Topic
- Renal and related cancers
- Type
- article
- Field-Weighted Citation Impact
- 0.81
Funders
- Associazione Bianca Garavaglia