To choose an appropriate protocol for treatment of Wilms tumor in conditions of limited resources.
We analyzed outcomes, advantages and disadvantages in application of SIOP 2001 and NWTS 5 protocols in our hospital. Patients with nephroblastoma admitted to National Children's Hospital in Hanoi, Vietnam, had been treated according to the NWTS 5 protocol from 2000-2005, and from 2008-2013 according to the SIOP 2001 protocol.
33 patients, stages I-III treated with NWTS 5 had estimated 5 year EFS 90.1% and OS 96.7% (mean follow up time 30.4 months); 58 patients, stages I-V, treated with SIOP 2001 had estimated 5 year EFS 71.5% and OS 80.9% (mean follow up time 27 months). Patients stage I-III treated with SIOP 2001 protocol had estimated 5 year EFS 77.5% and OS 84.1%. The complication and side effects were acceptable except in one patient treated with SIOP 2001 protocol who died as a complication of treatment. For patients treated with SIOP 2001, imaging diagnosis was confirmed by pathological examination in 78.3% cases.
Patients treated with NWTS 5 and SIOP 2001 protocols had good outcomes in a limited resources situation. Imaging and pathological diagnoses are challenging for medical staff in developing countries. Treatment approach should be based on medical staff competence and patient's condition. We recommend immediate operation for operable tumors and preoperative chemotherapy for inoperable cases.