3.1. Socio-demographic characteristics
Out of a total of 3,024 cases of children who visited the Department of Pediatrics during the study period, we recorded 99 cases of childhood cancers combined, representing a hospital frequency of 3.72%. Male predominance was observed (57.7% male versus 41.3% female) with a sex ratio of (H/F) of 1.3. The year 2018 saw a large number of patients during the period of our study: 53 children (53.5%). The average age was 5.67 - 3.85 years (8 months-17 years). As many boys as girls were affected ages 0-9 and 10-17. We noted that nearly 57.6% was between 0 and 9 years old.
Most of the patients lived in the city of Lubumbashi (69.2%) and a significant number came from different provinces other than Lubumbashi or even from countries other than the DRC. In (89.1%) cases, the children’s families had a low socio-economic level while households took care of the children at (96.04%).
It should also be noted that 58.2% of parents had a secondary education level and seventy-one households had consulted a general practitioner at first contact and among them, twenty-two (22.22%) had also consulted a traditional practitioner or see prior to the medical consultation (Table 1).
3.2. Time to diagnose and extend the disease
The diagnosis time of the disease was between 6 and 12 months with an average duration of 4.5 months. Most of the tumors in our series were located at the time of diagnosis at (52.5%) (31.7%) cancers had already metastasized. In the pediatric oncology department of the C.U.L. for (65.3%) cancer cases, their diagnosis was made within 48 hours of the first consultation.
During our study period, 99 cancers were recorded in children under 17 years of age and at diagnosis, 29.5% of cases were metastasized.
Retinoblastoma is the most common tumour in 29 cases (29.2%). Nephroblastoma comes in second place with 23 cases (23.3%) followed by Lymphomas of all forms with 17 cases (17.2%), leukemias (11.1), bone tumours (5%), sarcoma (5%), Central Nervous System Tumors (3%), Neuroblastoma (3%), Undifferentiated carcinoma nasopharyngeal type (UCNT) (2%), Squamous cell carcinoma (1%) hepatocarcinoma (1%). (Figure 1)
It should be noted that not all patients had easy access to treatment but almost (88%) had easy access to chemotherapy. Among them, (71.7%) chemotherapy targeted curative and (28.3%) palliative aim.
In their evolution after initiation of treatment, tumors in children showed remission in (21.2%) with an average survival of 2-1 years, and almost (27.1%) remained under substantive treatment. It was noted, a significant number of patients lost sight of and who discontinued treatment (11.1%) which indicates that the lethality given in our study is very limited. In (8.4%) they are followed for palliative care and (4.7%) have been transferred to specialist units in Europe or elsewhere. Let’s remember a large number of deaths from childhood cancer (35.3%) often due to the lack of financial means in the management and of cancers diagnosed in the terminal phase. (Table 2).