Wilms tumour in Malawi: Surgical staging to stratify postoperative chemotherapy?

Eric Borgstein, Steve Kamiza, Gordan Vujanic, Dalida Pidini, Simon Bailey, Tamiwe Tomoka, Kondwani Banda, Gertjan Kaspers, Elizabeth Molyneux, Trijn Israels

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Background: Wilms tumour postoperative chemotherapy is ideally stratified according to the pathologist's assessment of tumour stage and risk classification (tumour type). In sub-Saharan Africa results are often not available in time to influence therapy and in Malawi surgical staging has been used to stratify postoperative chemotherapy. Here we compare the results from surgical and both local pathology and central pathology review. Procedure: Children diagnosed with a Wilms tumour in Blantyre, Malawi between 2007 and 2011 were included if they had a nephrectomy and the pathology slides were available. All tumour specimens were assessed in three different ways: the local surgeon documented the surgical stage of the tumour, and the risk classification and pathology stage were assessed both by the local pathologist and by a SIOP central review pathologist in Europe. Results: Fifty patients had complete data available and were included in the analyses. Tumour risk classification differed between the local and central pathology review in only two patients (4%). Using central pathology review as the gold standard 60% of patients received the correct postoperative chemotherapy treatment based on surgical staging and 84% based on the local pathology stage and risk classification. Conclusion: Local pathology capacity building is needed to enable timely assessment and reporting.

Original languageEnglish
Pages (from-to)2180-2184
Number of pages5
JournalPediatric Blood and Cancer
Issue number12
Publication statusPublished - 1 Dec 2014
Externally publishedYes


  • Adapted treatment regimens
  • Africa
  • Low income countries
  • Nephroblastoma
  • Pathology
  • Peer review
  • Postoperative chemotherapy
  • Stratification
  • Wilms tumour


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