BACKGROUND: Treatment options for @entity3969 ( @entity3969 ) are costly and it affects the country's health budget and resources if adopted and implemented at the national level especially in developing countries with low or resource-challenged settings. AIM: The objective of this study is to evaluate the role and effectiveness of primary surgery in the treatment of stage II and III pediatric @entity3969 following the schedule indicated in the National @entity3969 Study (NWTS-4) in the institutes of two developing countries. @entity1 AND METHODS: The study enrolled 40 @entity1 who were primarily diagnosed as @entity3969 . They were divided into 2 equal groups. Group I (n = 20) included those @entity1 who have undergone neoadjuvant chemotherapy followed by surgery and postoperative chemotherapy, while group II (n = 20) included those @entity1 who have undergone primary surgery as an initial management followed by chemotherapy. After a mean postoperative follow-up period of 20  5 months, clinical and radiological evaluation was performed for all @entity1 . RESULTS: In group I, 15 @entity1 were preoperatively diagnosed as stage II and 5 @entity1 as stage III while in group II, 16 @entity1 were proved to be stage II and 4 @entity1 were stage III. After a follow up period, clinical and radiological evaluation using CT was performed on all @entity1 . In @entity1 with stage II, evidence of recurrence was noted in 4 @entity1 of group I whereas no @entity1 showed any evidence of recurrence in group II. In @entity1 with stage III, rebound increase in size was seen in 2 @entity1 in group I and only one @entity1 in group II. CONCLUSION: Primary surgery with appropriate adjuvant therapy improves the treatment results compared to the neoadjuvant chemotherapy and delayed surgery for @entity1 primarily diagnosed as @entity3969 . It may be used as a safe and effective tool in treating @entity3969 @entity1 with relatively no changes from the long administration schedules. This will have a highly positive impact in lowering treatment cost in developing countries.

Primary Surgery in Treatment of Stages II and III XXXX : A Developing Countries' Experience.

@entity3969 :: ('MESH:D009396', 'Disease') :: ["Wilms' Tumor", "Wilms' tumour", 'WT', 'stage II and III WT'] @entity1 :: ('9606', 'Species') :: ['children', 'patients', 'patient', 'PATIENTS']
@entity3969 :: (MESH:D009396,Disease) :: ['Wilms' Tumour']
