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Rodriguez-Romo L, Olaya Vargas A, Gupta S, Shalkow-Klincovstein J, Vega-Vega L, Reyes-Lopez A, Cicero-Oneto C, Mejia-Arangure J, Gonzalez-Ramella O, Pineiro-Retif R, Lopez-Facundo A, de los Angeles Del Campo-Martinez M, Tejocote I, Brennan K, Booth CM. Delivery of Pediatric Cancer Care in Mexico: A National Survey. J Glob Oncol 2018; 4:1-12. [PMID: 30084750 PMCID: PMC6223522 DOI: 10.1200/jgo.17.00238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Limited data describe the delivery of pediatric cancer care in Mexico. We report a nationwide survey of pediatric cancer units. Methods An electronic survey was distributed to 74 pediatric cancer units in Mexico to describe case volumes; organization of care; and availability of medical/surgical specialists, supportive care, complex therapies, and diagnostic services. Centers were classified as low (< 30 new patients/year), medium (30 to 59/year) and high (≥ 60/year). Results Sixty-two centers completed the survey (response rate, 84%). The median annual new case volume per center was 50 (interquartile range [IQR], 23 to 81). Thirty-four percent (n = 21), 26% (n = 16), and 40% (n = 25) of units were low-, medium-, and high-volume centers, respectively. Treatment units reported a median of two pediatric oncologists (IQR, 2) and one pediatric hematologist (IQR, 1 to 2). Availability of medical and surgical subspecialists varied by center size, with substantially more specialist support at higher-volume centers ( P < .01). Multidisciplinary tumor boards are available at 29% (six of 21), 56% (nine of 16), and 76% (19 of 25) of low- to high-volume centers, respectively ( P = .005). Radiation and palliative care services are available at 42% (n = 26) and 63% (n = 36) of all centers, which did not vary by center volume. Educational support for hospitalized children and school reintegration programs are available at 56% (n = 36) and 58% (n = 36) of centers, respectively. One third (38% [n = 23]) of centers reported that at least one half of patients were lost to follow-up during the transition from pediatric to adult programs. Conclusion A large variation exists in annual case volumes across Mexican pediatric cancer centers. Additional efforts to increase access to multidisciplinary, supportive, and palliative care across all pediatric cancer units in Mexico are required.
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Affiliation(s)
- Laura Rodriguez-Romo
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Alberto Olaya Vargas
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Sumit Gupta
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Jaime Shalkow-Klincovstein
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Lourdes Vega-Vega
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Alfonso Reyes-Lopez
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Carlo Cicero-Oneto
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Juan Mejia-Arangure
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Oscar Gonzalez-Ramella
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Rafael Pineiro-Retif
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Aracely Lopez-Facundo
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Maria de los Angeles Del Campo-Martinez
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Isidoro Tejocote
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Kelly Brennan
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Christopher M. Booth
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
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