Survival Outcomes of Wilms' Tumor in Pediatric Patients Treated at KFMC: A Retrospective Study of 15 years from 2007-2022

Background: Wilms' tumor is the most common malignant renal tumor in children, with high cure rates in high-income settings due to standardized treatment protocols.However, outcomes in different regions can vary based on treatment approaches and resource availability.This study aims to evaluate the overall survival and relapsefree survival of pediatric patients with Wilms' tumor treated at King Fahad Medical City over a 15-year period and compare institutional outcomes with national and international outcomes.Methods: A retrospective cohort study was conducted, including 94 pediatric patients diagnosed with Wilms' tumor and treated at KFMC between July 2007 and June 2022.Clinical, pathological, and treatment-related data were collected from hospital electronic systems.Survival analysis was performed using the Kaplan-Meier method. Results:The median age at diagnosis was 62.5 months, with a female predominance (60.6%).A significant proportion (46.8%) presented with pulmonary metastasis, and over 56% had stage III or IV disease.Delayed nephrectomy following neoadjuvant chemotherapy was the predominant surgical approach (79.8%).Anaplastic histology was found in 6.4%, and blastemal predominance in 29.7%.At final follow-up, 95.7% of patients were alive, and 88.3% remained relapse-free.The mean overall survival (OS) was 169.4 months, and the mean recurrence-free survival (RFS) was 145.4 months. Conclusion:This study highlights that adherence to international treatment protocols can lead to excellent survival outcomes in pediatric patients with Wilms' tumor, even in cases diagnosed at advanced stages.Continued emphasis on protocol-based care, early diagnosis, and integration of molecular prognostics will be crucial in sustaining and improving outcomes.