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Abdelhafeez A, Harrison D, Nugud F, Sanhouri K, Grant CN, Aronson DC, Bukhari Z, Israels T, Langer M, Sharma S, Munanzvi K, Muzira A, Moreno A, Ngongola A, Shalkow J, Abib S, Lakhoo K. Development of a template for operative reporting of pediatric cancer surgery in limited-resource settings by using a modified Delphi method. Pediatr Blood Cancer 2023; 70:e30650. [PMID: 37638812 DOI: 10.1002/pbc.30650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/12/2023] [Accepted: 08/17/2023] [Indexed: 08/29/2023]
Abstract
PURPOSE A comprehensive operative report for cancer surgery is crucial for accurate disease staging, risk stratification, and therapy escalation/de-escalation, which affects the outcome. Narrative operative reports may fail to include some critical findings. Furthermore, standardized operative reports can form the basis of a local registry, which is often lacking in limited-resource settings (LRSs). In adult literature, synoptic operative reports (SOR) contain more key findings than narrative operative reports. In the LRSs, where the capacity of diagnostic pathology services is typically suboptimal, the value of a thorough operative report is even greater. The aim of this study was to develop a SOR template to help standardize childhood cancer surgery reporting in LRSs. METHODS Twenty-three experts in pediatric cancer with extensive experience practicing in LRSs were invited to participate in a modified Delphi procedure. SOR domains for pediatric oncology surgery were drafted based on a literature search and then modified based on experts' opinions. The experts anonymously answered multiple rounds of online questionnaires until all domains and subdomains reached a consensus, which was predefined as 70% agreement. RESULTS Sixteen experts participated in the study, and two rounds of the survey were completed. Twenty-one domains were considered relevant, including demographics, diagnosis, primary site, preoperative disease stage, previous tumor biopsy or surgery, preoperative tumor rupture, neoadjuvant therapy, surgical access, type of resection, completeness of resection, tumor margin assessment, locoregional tumor extension, organ resection, intraoperative tumor spillage, vascular involvement, lymph node sampling, estimated blood loss, intraoperative complications and interventions to address them, specimen names, and specimen orientation. CONCLUSION We developed a SOR template for pediatric oncology surgery in LRSs. Consensus for all 21 domains and associated subdomains was achieved using a modified Delphi procedure.
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Affiliation(s)
| | - Derek Harrison
- Department of Paediatric Surgery, Chris Hani Baragwanath Academic Hospital, University of Witwatersrand, Johannesburg, South Africa
| | - Faisal Nugud
- Faculty of Medicine, University of Gezira, Wad Madani, Sudan
| | - Kanan Sanhouri
- Faculty of Medicine, University of Gezira, Wad Madani, Sudan
| | | | | | - Zaitun Bukhari
- Department of Paediatirc Surgery, Muhimbili National Hospital, Dar es Salaam, United Republic of Tanzania
| | - Trijin Israels
- Kamuzu University of Health Sciences (KUHeS), Blantyre, Malawi
| | - Monica Langer
- Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Shilpa Sharma
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | | | | | - Amabelle Moreno
- Division of Pediatric Surgery, University of the Philippines - Philippine General Hospital, Manila, Philippines
| | - Amon Ngongola
- Department of Pediatric Surgery, University Teaching Hospital, Lusaka, Zambia
| | - Jaime Shalkow
- Pediatric Surgery Oncology, ABC Cancer Centre, Mexico City, Mexico
| | - Simone Abib
- Department of Pediatric Surgery, Pediatric Oncology Institute - GRAACC - Federal University of São Paulo, São Paulo, São Paulo, Brazil
| | - Kokila Lakhoo
- Nuffield Department of Surgical Sciences, Oxford University, Oxford, UK
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Chitsike I, Paintsil V, Sung L, Njuguna F, Mavinkurve-Groothuis A, Kouya F, Hesseling P, Kaspers G, Afungchwi GM, Ilbawi A, Renner L, Pritchard-Jones K, Hessissen L, Molyneux E, Chagaluka G, Israels T. Working Together to Build a Better Future for Children With Cancer in Africa. JCO Glob Oncol 2021; 6:1076-1078. [PMID: 32673078 PMCID: PMC7392779 DOI: 10.1200/go.20.00170] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- Inam Chitsike
- Department of Pediatrics, College of Health Sciences, Harare, Zimbabwe
| | - Vivian Paintsil
- Directorate of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Lillian Sung
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Festus Njuguna
- Moi University/Moi Teaching and Referral Hospital, Eldoret, Kenya
| | | | - Francine Kouya
- Department of Pediatric Oncology, Mbingo Baptist Convention Hospital, Mbingo, Cameroon
| | - Peter Hesseling
- Department of Pediatrics and Child Health, Stellenbosch University, South Africa
| | - Gertjan Kaspers
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Amsterdam, the Netherlands
| | - Glenn M Afungchwi
- Department of Pediatric Oncology, Mbingo Baptist Convention Hospital, Mbingo, Cameroon
| | - Andre Ilbawi
- Global Initiative for Childhood Cancer, WHO, Geneva, Switzerland
| | - Lorna Renner
- Department of Child Health, University of Ghana Medical School, Accra, Ghana
| | | | - Laila Hessissen
- Pediatric Hematology and Oncology Center, Mohamed V University, Rabat, Morocco
| | | | | | - Trijn Israels
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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Iroh Tam PY, Dramowski A, Labi AK, Mujuru HA, Ogunbosi BO. Antimicrobial resistance among children in Africa: need for paediatric clinical trials. Expert Rev Anti Infect Ther 2020; 18:955-956. [PMID: 32538200 DOI: 10.1080/14787210.2020.1782741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Pui-Ying Iroh Tam
- Paediatrics and Child Health Research Group, Malawi-Liverpool Wellcome Trust Clinical Research Programme , Blantyre, Malawi.,Department of Paediatrics, University of Malawi College of Medicine , Blantyre, Malawi.,Department of Clinical Sciences, Liverpool School of Tropical Medicine , Liverpool, UK
| | - Angela Dramowski
- Department of Paediatrics, Stellenbosch University , Stellenbosch, South Africa
| | - Appiah-Korang Labi
- Department of Microbiology, Korle-Bu Teaching Hospital and University of Ghana Medical School , Accra, Ghana
| | - Hilda A Mujuru
- Department of Paediatrics, University of Zimbabwe College of Health Sciences , Harare, Zimbabwe
| | - Babatunde O Ogunbosi
- Department of Paediatrics, University College Hospital and University of Ibadan College of Medicine , Ibadan, Nigeria
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Chakumatha E, Weijers J, Banda K, Bailey S, Molyneux E, Chagaluka G, Israels T. Outcome at the end of treatment of patients with common and curable childhood cancer types in Blantyre, Malawi. Pediatr Blood Cancer 2020; 67:e28322. [PMID: 32391955 DOI: 10.1002/pbc.28322] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND The WHO Global Initiative for Childhood Cancer aims to increase survival to at least 60% for all children with cancer globally, with initial focus on six common curable cancer types. Frequent causes of treatment failure in low income countries (LICs) are treatment abandonment and death during treatment. Here, we report on the outcome at the end of treatment of patients with newly diagnosed common and curable cancer types, admitted in the Queen Elizabeth Central Hospital, Blantyre, Malawi. PROCEDURE Outcome at end of treatment was documented and analyzed retrospectively for all children with a working diagnosis of a common and curable cancer type (ALL, Hodgkin disease, Wilms tumor, retinoblastoma, and Burkitt lymphoma) admitted over a 2-year period. Patients with a misdiagnosis were excluded. Outcomes were categorized as alive without evidence of disease, treatment abandonment, death during treatment, or persistent disease. RESULTS We included 264 patients. Seven patients with a misdiagnosis were excluded. At the end of treatment, 53% (139 of 264) of patients were alive without evidence of disease, 19% (49 of 264) had abandoned treatment, 23% (61 of 264) had died during treatment, and 6% (15 of 264) had persistent disease. CONCLUSION Survival of children with common and curable cancers is (significantly) below 50%. Almost half (42%) of the patients either abandoned treatment or died during treatment. Strategies to enable parents to complete treatment of their child and improved supportive care are needed. Such interventions may need to be given priority to improve the currently poor survival.
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Affiliation(s)
| | - Janna Weijers
- Department of Paediatrics, College of Medicine, Blantyre, Malawi.,Academy Outreach and Department of Solid Tumours, Princess Máxima Center for Paediatric Oncology, Utrecht, The Netherlands
| | - Kondwani Banda
- Department of Paediatrics, College of Medicine, Blantyre, Malawi
| | - Simon Bailey
- Department of Paediatric Oncology, Sir James Spence Institute of Child Health, Royal Victoria Infirmary Queen, Newcastle, UK
| | | | - George Chagaluka
- Department of Paediatrics, College of Medicine, Blantyre, Malawi
| | - Trijn Israels
- Academy Outreach and Department of Solid Tumours, Princess Máxima Center for Paediatric Oncology, Utrecht, The Netherlands
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Khalek ER, Afungchwi GM, Beltagy ME, Mariam N, Zaki H, Israels T, Molyneux E, Howard SC, Patte C, Schoeman J, Ladas E, Zaghloul MS, ElDeen YS, Ahmed S, Kamal S, Bouffet E, Pritchard-Jones K, Hessissen L. Highlights from the 13th African Continental Meeting of the International Society of Paediatric Oncology (SIOP), 6-9 March 2019, Cairo, Egypt. Ecancermedicalscience 2019; 13:932. [PMID: 31281429 PMCID: PMC6592710 DOI: 10.3332/ecancer.2019.932] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Indexed: 01/17/2023] Open
Abstract
The 13th African continental meeting of the international society of paediatric oncology, held on 6-9 March 2019 in Cairo, was organised in collaboration with the Children Cancer Hospital (57357) in Egypt and the global parents' organisation (Childhood Cancer International) and supported by a large international faculty. With 629 delegates from 37 countries (24 African), this was the largest forum of healthcare professionals focused on children and young people with cancer in Africa to showcase advances and discuss further improvements. Three targeted workshops, on nursing care, pharmacy and nutrition, attracted large numbers and catalysed new collaborative initiatives in supportive care studies, extended roles for pharmacists in quality control and care delivery and addressed malnutrition concurrently with cancer treatment. The Collaborative Wilms Tumour Africa Project, open in seven sub-Saharan countries, and the trials in Burkitt's lymphoma reported encouraging outcomes with further initiatives in supportive care (the supportive care for children with cancer in Africa project). While acknowledging deficits in radiotherapy provision, available in only 23 of 52 African countries, centres with facilities reported their technical advances that benefit patients. Of great importance for children with brain tumours, who are underdiagnosed in Africa, was the first announcement of African paediatric neuro-oncology society, whose 63 current members aim to tackle the shortage of neurosurgeons through training fellowships, workshops and a dedicated conference. The congress provided the opportunity to discuss how African countries will work with the WHO global initiative aiming to improve childhood cancer survival to 60% in all countries by 2030. This conference report is dedicated to the three Kenyan delegates who died tragically on the Ethiopian Airlines flight ET302 on their way home, full of new ideas and pride in what they had achieved so far. All those who heard their presentations are determined to continue their excellent work to improve cancer care for children in Africa.
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Affiliation(s)
- Elhamy Rifky Khalek
- Professor of Paediatric Oncology, Faculty of Medicine, Zagazig University, Children's Cancer Hospital Egypt 57357, Cairo 11617, Egypt
| | - Glenn M Afungchwi
- Manager, Cameroon Baptist Convention Health Services Childhood Cancer Programme, Cameroon University of Stellenbosch, Stellenbosch 7602, South Africa
| | - Mohamed El Beltagy
- Professor of neurosurgery, Faculty of Medicine, Cairo University, Kasr El Aini, Cairo, and Head of Neurosurgery, Children's Cancer Hospital Egypt 57357, Cairo 11617, Egypt
| | - Ndagire Mariam
- Nursing officer, Uganda Cancer Institute, Kampala, PO Box 3935 Uganda
| | - Hoda Zaki
- Dean, Faculty of Nursing, Helwan University, Modern University for Technology and Information (MTI), Cairo, Egypt
| | - Trijn Israels
- Princess Màxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
| | - Elizabeth Molyneux
- Paediatric Department, College of Medicine/Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Scott C Howard
- The University of Tennessee Health Science Center, Memphis, TN 38163 USA
| | - Catherine Patte
- CLCC G Groupe Franco-Africain d'Oncologie Pédiatrique (GFAOP), Institut Gustave Roussy, France and GFAOP, 94800 Villejuif, France
| | - Judy Schoeman
- Chief dietician, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town 7530, South Africa
| | - Elena Ladas
- Associate Professor for Global Integrative Medicine, Director, Integrative Therapies Program, Columbia University Medical Center, USA
| | - Mohamed S Zaghloul
- Professor of Radiation Oncology, National Cancer Institute; Chair, Radiation Oncology Department, Children's Cancer Hospital Egypt 57357, Cairo, Egypt
| | - Yasser S ElDeen
- Professor of Pediatric Surgery, Alexandria University, Alexandria 21568, Egypt
| | - Soha Ahmed
- Chairman, Clinical Oncology Department, Aswan University and Consultant, Children's Cancer Hospital Egypt 57357, Cairo, Egypt
| | - Sherif Kamal
- Director, Department of Pharmaceutical Services, Children's Cancer Hospital Egypt 57357, Cairo, Egypt
| | - Eric Bouffet
- President, International Society of Paediatric Oncology (SIOP), Professor of Neuro-oncology, Sick Children's Hospital, Toronto ON M5G 1X8, Canada
| | - Kathy Pritchard-Jones
- SIOP President-elect, Professor of Paediatric Oncology, UCL Great Ormond Street Institute of Child Health, University College London, London WC1E 6BT, UK
| | - Laila Hessissen
- SIOP Africa Continental President, Professor of Paediatrics, Pediatric Haematology and Oncology Center, University Mohamed V Rabat, Rabat BP.8007.UN, Morocco
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Lam CG, Howard SC, Bouffet E, Pritchard-Jones K. Science and health for all children with cancer. Science 2019; 363:1182-1186. [DOI: 10.1126/science.aaw4892] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Each year ~429,000 children and adolescents aged 0 to 19 years are expected to develop cancer. Five-year survival rates exceed 80% for the 45,000 children with cancer in high-income countries (HICs) but are less than 30% for the 384,000 children in lower-middle-income countries (LMICs). Improved survival rates in HICs have been achieved through multidisciplinary care and research, with treatment regimens using mostly generic medicines and optimized risk stratification. Children’s outcomes in LMICs can be improved through global collaborative partnerships that help local leaders adapt effective treatments to local resources and clinical needs, as well as address common problems such as delayed diagnosis and treatment abandonment. Together, these approaches may bring within reach the global survival target recently set by the World Health Organization: 60% survival for all children with cancer by 2030.
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