Surgical Treatment and Prognosis of Paediatric Wilms Tumour at University of Nigeria Teaching Hospital, Enugu

Wilms tumour (nephroblastoma) is the most common renal malignancy in Nigerian children, yet outcomes remain suboptimal compared to high-income country benchmarks due to late diagnosis and limited access to multimodal therapy. This study reviews the surgical treatment approaches and prognostic outcomes of paediatric Wilms tumour at University of Nigeria Teaching Hospital (UNTH), Enugu State, South East Nigeria, from 2019 to 2023. A retrospective case review of 55 histologically confirmed cases was conducted. Data captured included age at presentation, tumour stage, nephrectomy approach, receipt of chemotherapy, pathological subtype, and two-year survival outcomes. Descriptive statistics were applied. The majority of patients (64%) presented at stage III or IV. Radical nephrectomy was performed in 89% of cases, with postoperative chemotherapy administered to 68% of patients. Two-year overall survival was 58%, compared to international benchmarks exceeding 85%. Advanced stage at presentation and unfavorable histology were the most significant prognostic determinants. Delayed referral from primary care facilities and inconsistent chemotherapy supply were identified as modifiable barriers. The study recommends pediatric oncology outreach programs targeting early detection and timely referral to tertiary centers in South East Nigeria. Keywords: Wilms tumour, nephroblastoma, paediatric surgery, UNTH Enugu, survival