Wilms' Tumor: Distribution, Demographics, and Outcomes in Sanaa City

Background: Wilms’ tumor (WT) is the most common pediatric renal malignancy, accounting for approximately 90% of kidney tumors in children. While outcomes in high-income countries exceed 90% survival, data from low-resource settings remain scarce, and no published series from Yemen exist. Objective: To describe the demographic distribution, clinical presentation, management patterns, and short-term outcomes of pediatric WT cases in Sana’a City, Yemen. Methods: This prospective study included all children aged ≤15 years with histologically confirmed WT, managed across governmental and private hospitals in Sana’a between January 2021 and December 2022. Demographic, clinical, radiological, surgical, and histopathological data were collected using a standardized case report form. Tumors were staged according to the Children’s Oncology Group (COG) criteria. Treatment modalities and outcomes, including event-free survival and overall survival at two years. Results: Fourteen patients were identified, with a male predominance (71.4%) and mean age 3.6 ± 3.5 years. Abdominal mass was the most common presentation (85.7%). Right-sided tumors predominated (64.3%), and all lesions were solid. According to COG staging, 35.7% were Stage I, 50.0% Stage II, and 14.3% Stage III; all had favorable histology. Preoperative chemotherapy was administered in 28.6% of patients, all underwent surgical resection, and 21.4% received postoperative chemotherapy. No patient received radiotherapy. At a median follow-up of 15 months (range: 7–22), 92.9% achieved complete remission, and one patient (7.1%) relapsed and died 18 months postoperatively. Conclusion: Pediatric WT in Sana’a City presents predominantly in early stages with favorable histology, but access to multimodal therapy—particularly radiotherapy—remains limited. The high remission rate is encouraging, but long-term follow-up and resource optimization are essential to improve outcomes and align with international standards.