Introduction
There is a shortage of data about the epidemiology, pathology,
treatment, and prognosis of Wilms tumor from Sudan. Dafalla O. Abuidris
et al. .1 published one study in 2008. They noted a
high proportion of locally advanced and metastatic disease (Stage III
(67.6%) and Stage IV (10.8%).) and poor results. This group reported a
survival rate of 11%.
Sudan Population is 43 746 000 2. In 2019, The urban
population for Sudan accounted for 34.9 %. In 2018, the population aged
0-14 years for Sudan was 40.5 % 3. Forty-seven
percent of the population lives below the poverty line. Twenty-six
percent of people living in Khartoum state is below the poverty line.
Poverty increase to 70% in the North Darfur western Sudan4.
This study is conducted in the Khartoum oncology hospital (KOH). It is a
government hospital and the larger of two oncology centers in Sudan. The
hospital is state-funded. Necessary investigations, chemotherapy, and
radiotherapy are provided free. The oncology unit treats children from
all over Sudan. It is situated in Khartoum, which has a population of
9.0 million. Many patients come from rural areas.
The department of Pediatric hematology-oncology was established in April
2004. Three full-time consultants staff the oncology unit. The unit
accepts an average of 350 new patients for treatment per year. KOH lacks
Intensive care facilities, and there is no department of pediatric
surgery. The pediatric oncology unit accepts Wilms tumor patients after
surgery or biopsy from all over Sudan. General pediatric surgeons from
other hospitals perform surgery then refer the patients. A qualified
radiation oncologist administers radiotherapy. Due to technical
problems, lung and whole abdomen radiotherapy are not possible to treat.
Three-D radiotherapy is not available. The radiology department lacks CT
and MRI machines.
This study is conducted to identify the obstacles in managing Wilms
tumor. It also assesses the impact of the establishment of the pediatric
oncology department on the outcome of Wilms tumor.