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).