Table 1 Current approach to Wilms’ tumor management in LMICs
n (%) | |
|---|---|
Initial biopsy | |
Do you obtain biopsy routinely first for imaging suspected Wilms’ tumor? | |
Yes | 29 (21.2%) |
No | 108 (78.8%) |
Approach | |
What is your approach to Wilms’ tumor? | |
Upfront resection | 42 (30.7%) |
Delayed resection (after preoperative chemotherapy) | 94 (68.6%) |
Omitted | 1 (0.7%) |
Reason for approach | |
Why have you adopted this approach? | |
To follow specific protocol | 60 (43.8%) |
To decrease tumor rupture | 30 (21.9%) |
To decrease other organ resection or complications | 11 (8.0%) |
To follow oncologist or surgeon preference | 9 (6.6%) |
To decrease intensity of therapy required | 8 (5.8%) |
Because of delayed access to surgery | 7 (5.1%) |
To decrease treatment abandonment | 6 (4.4%) |
Because of delayed access to chemotherapy | 4 (2.9%) |
Omitted | 2 (1.5%) |
Goal for timing of resection | |
Select the most important goal of therapy that timing of resection may affect. | |
Prevent tumor spillage and upstaging | 63 (46.0%) |
Prevent bleeding, complication, or other organ resections | 28 (20.4%) |
Prevent wrong chemotherapy or overtreatment in favorable biology | 18 (13.1%) |
Prevent delayed initiation of therapy | 18 (13.1%) |
Ensure accurate staging of lymph nodes | 10 (7.3%) |
Tumor spillage | |
Do you think that upfront resection may increase risk of tumor spillage or complications in LMIC setting? | |
Yes | 97 (70.8%) |
No | 40 (29.2%) |