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.