TABLE 4:

High-risk features identified in patients diagnosed with Wilms tumor in LMIC.

Characteristic	Sub-Saharan Africa* 65	AHOPCA** 70
Year (s)	2014–2018	2012–2015
No. Patients.	201	182
Age (median)	3.6 y	3.5 y
Diagnostic approach	Clinical, abdominal US, chest x-ray	Abdominal/chest CT if available; otherwise, clinical, abdominal US, chest x-ray
Tumor volume	Median Size: 14 cm	Median Volume: 579 cc
% Advanced disease	Stage IV: 62 (31%)	Stage III: 116 (63%) Stage IV: 37 (20%)
Radiotherapy	Available in Ghana but not in Malawi or Cameroon.	Available, with late delivery
Chemotherapy (drugs used)	SIOP-Adapted. (VAD)	COG-Adapted. (VAD and CE)
Abandonment	24/201 (12%)	19/182 (10%)
Deaths (First event)	30/201 (15%)	5/182 (3%)
Survival	49%	68%

^*Sub-Saharan Africa: Includes centers from Malawi (1), Cameroon (3), and Ghana (2).

^**AHOPCA: Includes centers from Guatemala (1), El Salvador (1), Honduras (2), Nicaragua (1), and Dominican Republic (1).

VAD: Vincristine + actinomycin D +/− Doxorubicin.

CE: Cyclophosphamide and Etoposide (Note: intensified for high-risk cases).