Skip to main content
Erschienen in: Child's Nervous System 3/2019

04.01.2019 | Original Article

Patterns, treatments, and outcomes of pediatric central nervous system tumors in Sudan: a single institution experience

verfasst von: M. Mohammed Ali Elhassan, A. Abdalla Mohamedani, H. Hussein Mohammed Osman, N. Osman Yousif, N. Mohamed Elhaj, I. Qaddoumi

Erschienen in: Child's Nervous System | Ausgabe 3/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Studies of epidemiology, treatment modalities, and outcomes of childhood central nervous system (CNS) tumors in Sudan are scarce. To address this shortcoming, we evaluated baseline information about the epidemiology, treatment types, and outcomes of childhood CNS tumors at the National Cancer Institute, University of Gezira (NCI-UG) in Wad Madani, Sudan.

Methods

We performed a retrospective health facility-based study of children with CNS tumors who were treated at the NCI-UG from January 2000 to December 2015.

Results

A total of 62 (5.4% of all childhood cancers) pediatric patients with CNS tumors were identified over the study period. Tumors were more common among male children and involved the infratentorial compartment in 58% of cases. The median age at diagnosis was 9 years (range, 2–14 years). Approximately 60% (n = 37) of the study population had histology-determined diagnoses. Astrocytomas and medulloblastomas were the most common tumors in these cases. The mean time to diagnosis was 6 months (SD, 9). During the study period, the number of children with CNS tumors who were referred for treatment at the NCI-UG increased every year. Of the 37 patients who received surgical interventions, 8 received gross total resections, 20 received partial resections, and 24 received postoperative radiotherapy. The treatment abandonment rate was 11%. The 2-year and 5-year survival rates were 33% and 13%, respectively.

Conclusion

Our findings reveal a high incidence of poor outcomes for patients with CNS tumors in Sudan, which is most likely due to many distinct factors.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Baldwin RT, Preston-Martin S (2004) Epidemiology of brain tumors in childhood--a review. Toxicol Appl Pharmacol 199:118–131PubMedCrossRef Baldwin RT, Preston-Martin S (2004) Epidemiology of brain tumors in childhood--a review. Toxicol Appl Pharmacol 199:118–131PubMedCrossRef
2.
Zurück zum Zitat Steliarova-Foucher E, Colombet M, Ries LAG, Moreno F, Dolya A, Bray F, Hesseling P, Shin HY, Stiller CA, IICC-3 Contributors (2017) International incidence of childhood cancer, 2001-10: a population-based registry study. Lancet Oncol 18:719–731PubMedPubMedCentralCrossRef Steliarova-Foucher E, Colombet M, Ries LAG, Moreno F, Dolya A, Bray F, Hesseling P, Shin HY, Stiller CA, IICC-3 Contributors (2017) International incidence of childhood cancer, 2001-10: a population-based registry study. Lancet Oncol 18:719–731PubMedPubMedCentralCrossRef
3.
Zurück zum Zitat Kaatsch P, Rickert CH, Kuhl J, Schuz J, Michaelis J (2001) Population-based epidemiologic data on brain tumors in German children. Cancer 92:3155–3164PubMedCrossRef Kaatsch P, Rickert CH, Kuhl J, Schuz J, Michaelis J (2001) Population-based epidemiologic data on brain tumors in German children. Cancer 92:3155–3164PubMedCrossRef
4.
Zurück zum Zitat Howard SC, Metzger ML, Wilimas JA, Quintana Y, Pui CH, Robison LL, Ribeiro RC (2008) Childhood cancer epidemiology in low-income countries. Cancer 112:461–472PubMedCrossRef Howard SC, Metzger ML, Wilimas JA, Quintana Y, Pui CH, Robison LL, Ribeiro RC (2008) Childhood cancer epidemiology in low-income countries. Cancer 112:461–472PubMedCrossRef
5.
Zurück zum Zitat Stiller CA, Parkin DM (1996) Geographic and ethnic variations in the incidence of childhood cancer. Brit Med Bull 52:682–703PubMedCrossRef Stiller CA, Parkin DM (1996) Geographic and ethnic variations in the incidence of childhood cancer. Brit Med Bull 52:682–703PubMedCrossRef
8.
Zurück zum Zitat Elhassan M, Mohamedani A, Yousif N, Elhaj N, Qaddoumi I, Abuidres D (2018) Epidemiological review of childhood cancers in central Sudan. S Afr J Oncol 2:1–7CrossRef Elhassan M, Mohamedani A, Yousif N, Elhaj N, Qaddoumi I, Abuidres D (2018) Epidemiological review of childhood cancers in central Sudan. S Afr J Oncol 2:1–7CrossRef
9.
Zurück zum Zitat Hadley LG, Rouma BS, Saad-Eldin Y (2012) Challenge of pediatric oncology in Africa. Sem Pediatr Surg 21:136–141CrossRef Hadley LG, Rouma BS, Saad-Eldin Y (2012) Challenge of pediatric oncology in Africa. Sem Pediatr Surg 21:136–141CrossRef
10.
Zurück zum Zitat Reutfors J, Kramarova E, Weiderpass E, Monge P, Wesseling C, Ahlbom A (2002) Central nervous system tumours in children in Costa Rica, 1981-96. Pediatr Perinat Epidemiol 16:219–225CrossRef Reutfors J, Kramarova E, Weiderpass E, Monge P, Wesseling C, Ahlbom A (2002) Central nervous system tumours in children in Costa Rica, 1981-96. Pediatr Perinat Epidemiol 16:219–225CrossRef
11.
Zurück zum Zitat Elhassan MMA, Osman HHM, Parkes J (2017) Posterior cranial fossa tumours in children at National Cancer Institute, Sudan: a single institution experience. Childs Nerv Syst 33:1303–1308PubMedCrossRef Elhassan MMA, Osman HHM, Parkes J (2017) Posterior cranial fossa tumours in children at National Cancer Institute, Sudan: a single institution experience. Childs Nerv Syst 33:1303–1308PubMedCrossRef
12.
Zurück zum Zitat Elhaj A, Osman N, Alobeid A, Abdallah A, Abuidris D (2010) Pattern of brain tumours among children in Central Sudan. Sudan J Pediatr Child Health 10:32–34 Elhaj A, Osman N, Alobeid A, Abdallah A, Abuidris D (2010) Pattern of brain tumours among children in Central Sudan. Sudan J Pediatr Child Health 10:32–34
13.
Zurück zum Zitat Aghadiuno PU, Adeloye A, Olumide AA, Nottidge VA (1985) Intracranial neoplasms in children in Ibadan, Nigeria. Childs Nerv Syst 1:39–44PubMedCrossRef Aghadiuno PU, Adeloye A, Olumide AA, Nottidge VA (1985) Intracranial neoplasms in children in Ibadan, Nigeria. Childs Nerv Syst 1:39–44PubMedCrossRef
14.
Zurück zum Zitat Peacock WJ, Lazareff JA, Levin CV (1987) Childhood brain tumours in Cape Town. S Afr Med J 71:5–8PubMed Peacock WJ, Lazareff JA, Levin CV (1987) Childhood brain tumours in Cape Town. S Afr Med J 71:5–8PubMed
15.
Zurück zum Zitat Olasode BJ, Shokunbi MT, Aghadiuno PU (2000) Intracranial neoplasms in Ibadan, Nigeria. E Afr Med J 77:4–8 Olasode BJ, Shokunbi MT, Aghadiuno PU (2000) Intracranial neoplasms in Ibadan, Nigeria. E Afr Med J 77:4–8
16.
Zurück zum Zitat Bellil S, Limaiem F, Mahfoudhi H, Bellil K, Chelly I, Mekni A, Jemel H, Khaldi M, Haouet S, Zitouna M, Kchir N (2008) Descriptive epidemiology of childhood central nervous system tumours in Tunisia. Experience of a single institution over a 15-year period (1990-2004). Pediatr Neurosurg 44:382–387PubMedCrossRef Bellil S, Limaiem F, Mahfoudhi H, Bellil K, Chelly I, Mekni A, Jemel H, Khaldi M, Haouet S, Zitouna M, Kchir N (2008) Descriptive epidemiology of childhood central nervous system tumours in Tunisia. Experience of a single institution over a 15-year period (1990-2004). Pediatr Neurosurg 44:382–387PubMedCrossRef
17.
Zurück zum Zitat Karkouri M, Zafad S, Khattab M, Benjaafar N, El Kacemi H, Sefiani S, Kettani F, Dey S, Soliman AS (2010) Epidemiologic profile of pediatric brain tumors in Morocco. Childs Nerv Syst 26:1021–1027PubMedPubMedCentralCrossRef Karkouri M, Zafad S, Khattab M, Benjaafar N, El Kacemi H, Sefiani S, Kettani F, Dey S, Soliman AS (2010) Epidemiologic profile of pediatric brain tumors in Morocco. Childs Nerv Syst 26:1021–1027PubMedPubMedCentralCrossRef
18.
Zurück zum Zitat El-Gaidi MA (2011) Descriptive epidemiology of pediatric intracranial neoplasms in Egypt. Pediatr Neurosurg 47:385–395PubMedCrossRef El-Gaidi MA (2011) Descriptive epidemiology of pediatric intracranial neoplasms in Egypt. Pediatr Neurosurg 47:385–395PubMedCrossRef
19.
Zurück zum Zitat Harmouch A, Taleb M, Lasseini A, Maher M, Sefiani S (2012) Epidemiology of pediatric primary tumors of the nervous system: a retrospective study of 633 cases from a single Moroccan institution. Neuro-Chirurgie 58:14–18PubMedCrossRef Harmouch A, Taleb M, Lasseini A, Maher M, Sefiani S (2012) Epidemiology of pediatric primary tumors of the nervous system: a retrospective study of 633 cases from a single Moroccan institution. Neuro-Chirurgie 58:14–18PubMedCrossRef
20.
Zurück zum Zitat Stagno V, Mugamba J, Ssenyonga P, Kaaya BN, Warf BC (2014) Presentation, pathology, and treatment outcome of brain tumors in 172 consecutive children at CURE Children’s Hospital of Uganda. The predominance of the visible diagnosis and the uncertainties of epidemiology in sub-Saharan Africa. Childs Nerv Syst 30:137–146PubMedCrossRef Stagno V, Mugamba J, Ssenyonga P, Kaaya BN, Warf BC (2014) Presentation, pathology, and treatment outcome of brain tumors in 172 consecutive children at CURE Children’s Hospital of Uganda. The predominance of the visible diagnosis and the uncertainties of epidemiology in sub-Saharan Africa. Childs Nerv Syst 30:137–146PubMedCrossRef
21.
Zurück zum Zitat Uche EO, Shokunbi MT, Malomo AO, Akang EE, Lagunju I, Amanor-Boadu SD (2013) Pediatric brain tumors in Nigeria: clinical profile, management strategies, and outcome. Childs Nerv Syst 29:1131–1135PubMedCrossRef Uche EO, Shokunbi MT, Malomo AO, Akang EE, Lagunju I, Amanor-Boadu SD (2013) Pediatric brain tumors in Nigeria: clinical profile, management strategies, and outcome. Childs Nerv Syst 29:1131–1135PubMedCrossRef
22.
Zurück zum Zitat Farinotti M, Ferrarini M, Solari A, Filippini G (1998) Incidence and survival of childhood CNS tumours in the region of Lombardy, Italy. Brain 121:1429–1436PubMedCrossRef Farinotti M, Ferrarini M, Solari A, Filippini G (1998) Incidence and survival of childhood CNS tumours in the region of Lombardy, Italy. Brain 121:1429–1436PubMedCrossRef
23.
Zurück zum Zitat Cho KT, Wang KC, Kim SK, Shin SH, Chi JG, Cho BK (2002) Pediatric brain tumors: statistics of SNUH, Korea (1959-2000). Childs Nerv Syst 18:30–37PubMedCrossRef Cho KT, Wang KC, Kim SK, Shin SH, Chi JG, Cho BK (2002) Pediatric brain tumors: statistics of SNUH, Korea (1959-2000). Childs Nerv Syst 18:30–37PubMedCrossRef
24.
Zurück zum Zitat Rickert CH, Paulus W (2001) Epidemiology of central nervous system tumors in childhood and adolescence based on the new WHO classification. Childs Nerv Syst 17:503–511PubMedCrossRef Rickert CH, Paulus W (2001) Epidemiology of central nervous system tumors in childhood and adolescence based on the new WHO classification. Childs Nerv Syst 17:503–511PubMedCrossRef
25.
Zurück zum Zitat Rosemberg S, Fujiwara D (2005) Epidemiology of pediatric tumors of the nervous system according to the WHO 2000 classification: a report of 1,195 cases from a single institution. Childs Nerv Syst 21:940–944PubMedCrossRef Rosemberg S, Fujiwara D (2005) Epidemiology of pediatric tumors of the nervous system according to the WHO 2000 classification: a report of 1,195 cases from a single institution. Childs Nerv Syst 21:940–944PubMedCrossRef
26.
Zurück zum Zitat Lashley PM, Clarke H, Archer EY (1991) Primary pediatric brain tumours in Barbados: 10-year analysis (1978-1988). J Tropic Pediatr 37:64–66CrossRef Lashley PM, Clarke H, Archer EY (1991) Primary pediatric brain tumours in Barbados: 10-year analysis (1978-1988). J Tropic Pediatr 37:64–66CrossRef
27.
Zurück zum Zitat Gjerris F, Agerlin N, Borgesen SE, Buhl L, Haase J, Klinken L, Mortensen AC, Olsen JH, Ovesen N, Reske-Nielsen E, Schmidt K (1998) Epidemiology and prognosis in children treated for intracranial tumours in Denmark 1960-1984. Childs Nerv Syst 14:302–311PubMedCrossRef Gjerris F, Agerlin N, Borgesen SE, Buhl L, Haase J, Klinken L, Mortensen AC, Olsen JH, Ovesen N, Reske-Nielsen E, Schmidt K (1998) Epidemiology and prognosis in children treated for intracranial tumours in Denmark 1960-1984. Childs Nerv Syst 14:302–311PubMedCrossRef
28.
Zurück zum Zitat Kadri H, Mawla AA, Murad L (2005) Incidence of childhood brain tumors in Syria (1993-2002). Pediatr Neurosurg 41:173–177PubMedCrossRef Kadri H, Mawla AA, Murad L (2005) Incidence of childhood brain tumors in Syria (1993-2002). Pediatr Neurosurg 41:173–177PubMedCrossRef
29.
Zurück zum Zitat Zhou D, Zhang Y, Liu H, Luo S, Luo L, Dai K (2008) Epidemiology of nervous system tumors in children: a survey of 1,485 cases in Beijing Tiantan Hospital from 2001 to 2005. Pediatr Neurosurg 44:97–103PubMedCrossRef Zhou D, Zhang Y, Liu H, Luo S, Luo L, Dai K (2008) Epidemiology of nervous system tumors in children: a survey of 1,485 cases in Beijing Tiantan Hospital from 2001 to 2005. Pediatr Neurosurg 44:97–103PubMedCrossRef
30.
Zurück zum Zitat Wilne S, Collier J, Kennedy C, Koller K, Grundy R, Walker D (2007) Presentation of childhood CNS tumours: a systematic review and meta-analysis. Lancet Oncol 8:685–695PubMedCrossRef Wilne S, Collier J, Kennedy C, Koller K, Grundy R, Walker D (2007) Presentation of childhood CNS tumours: a systematic review and meta-analysis. Lancet Oncol 8:685–695PubMedCrossRef
31.
Zurück zum Zitat Armstrong GT (2010) Long-term survivors of childhood central nervous system malignancies: the experience of the childhood cancer survivor study. Eur J Pediatr Neurol 14:298–303CrossRef Armstrong GT (2010) Long-term survivors of childhood central nervous system malignancies: the experience of the childhood cancer survivor study. Eur J Pediatr Neurol 14:298–303CrossRef
32.
Zurück zum Zitat Mehta V, Chapman A, McNeely PD, Walling S, Howes WJ (2002) Latency between symptom onset and diagnosis of pediatric brain tumors: an Eastern Canadian geographic study. Neurosurgery 51:365–372PubMedCrossRef Mehta V, Chapman A, McNeely PD, Walling S, Howes WJ (2002) Latency between symptom onset and diagnosis of pediatric brain tumors: an Eastern Canadian geographic study. Neurosurgery 51:365–372PubMedCrossRef
34.
Zurück zum Zitat Dobrovoljac M, Hengartner H, Boltshauser E, Grotzer MA (2002) Delay in the diagnosis of paediatric brain tumours. Eur J Pediatr 161:663–667PubMedCrossRef Dobrovoljac M, Hengartner H, Boltshauser E, Grotzer MA (2002) Delay in the diagnosis of paediatric brain tumours. Eur J Pediatr 161:663–667PubMedCrossRef
35.
Zurück zum Zitat Fukuoka K, Yanagisawa T, Suzuki T, Shirahata M, Adachi JI, Mishima K, Fujimaki T, Matsutani M, Nishikawa R (2014) Duration between onset and diagnosis in central nervous system tumors: impact on prognosis and functional outcome. Pediatr Int 56:829–833PubMedCrossRef Fukuoka K, Yanagisawa T, Suzuki T, Shirahata M, Adachi JI, Mishima K, Fujimaki T, Matsutani M, Nishikawa R (2014) Duration between onset and diagnosis in central nervous system tumors: impact on prognosis and functional outcome. Pediatr Int 56:829–833PubMedCrossRef
36.
Zurück zum Zitat Arnautovic A, Billups C, Broniscer A, Gajjar A, Boop F, Qaddoumi I (2015) Delayed diagnosis of childhood low-grade glioma: causes, consequences, and potential solutions. Childs Nerv Syst 31:1067–1077PubMedPubMedCentralCrossRef Arnautovic A, Billups C, Broniscer A, Gajjar A, Boop F, Qaddoumi I (2015) Delayed diagnosis of childhood low-grade glioma: causes, consequences, and potential solutions. Childs Nerv Syst 31:1067–1077PubMedPubMedCentralCrossRef
37.
Zurück zum Zitat Stocco C, Pilotto C, Passone E, Nocerino A, Tosolini R, Pusiol A, Cogo P (2017) Presentation and symptom interval in children with central nervous system tumors. A single-center experience. Childs Nerv Syst 33:2109–2116PubMedCrossRef Stocco C, Pilotto C, Passone E, Nocerino A, Tosolini R, Pusiol A, Cogo P (2017) Presentation and symptom interval in children with central nervous system tumors. A single-center experience. Childs Nerv Syst 33:2109–2116PubMedCrossRef
38.
Zurück zum Zitat Azizi AA, Heßler K, Leiss U, Grylli C, Chocholous M, Peyrl A, Gojo J, Slavc I (2017) From symptom to diagnosis—the prediagnostic symptomatic interval of pediatric central nervous system tumors in Austria. Pediatr Neurol 76:27–36PubMedCrossRef Azizi AA, Heßler K, Leiss U, Grylli C, Chocholous M, Peyrl A, Gojo J, Slavc I (2017) From symptom to diagnosis—the prediagnostic symptomatic interval of pediatric central nervous system tumors in Austria. Pediatr Neurol 76:27–36PubMedCrossRef
39.
Zurück zum Zitat Vasquez L, Diaz R, Chavez S, Tarrillo F, Maza I, Hernandez E, Oscanoa M, García J, Geronimo J, Rossell N (2017) Factors associated with abandonment of therapy by children diagnosed with solid tumors in Peru. Pediatr Blood Cancer 65:e27007CrossRef Vasquez L, Diaz R, Chavez S, Tarrillo F, Maza I, Hernandez E, Oscanoa M, García J, Geronimo J, Rossell N (2017) Factors associated with abandonment of therapy by children diagnosed with solid tumors in Peru. Pediatr Blood Cancer 65:e27007CrossRef
40.
Zurück zum Zitat Mansell R, Purssell E (2017) Treatment abandonment in children with cancer in Sub-Saharan Africa: systematic literature review and meta-analysis. J Adv Nurs 74:800–808PubMedCrossRef Mansell R, Purssell E (2017) Treatment abandonment in children with cancer in Sub-Saharan Africa: systematic literature review and meta-analysis. J Adv Nurs 74:800–808PubMedCrossRef
41.
Zurück zum Zitat Friedrich P, Lam CG, Kaur G, Itriago E, Ribeiro RC, Arora RS (2016) Determinants of treatment abandonment in childhood cancer: results from a global survey. PLoS One 11:e0163090PubMedPubMedCentralCrossRef Friedrich P, Lam CG, Kaur G, Itriago E, Ribeiro RC, Arora RS (2016) Determinants of treatment abandonment in childhood cancer: results from a global survey. PLoS One 11:e0163090PubMedPubMedCentralCrossRef
42.
Zurück zum Zitat Mostert S, Njuguna F, Van de Ven PM, Olbara G, Kemps LJ, Musimbi J, Strother RM, Aluoch LM, Skiles J, Buziba NG, Sitaresmi MN (2014) Influence of health-insurance access and hospital retention policies on childhood cancer treatment in Kenya. Pediatr Blood Cancer 61:913–918 Mostert S, Njuguna F, Van de Ven PM, Olbara G, Kemps LJ, Musimbi J, Strother RM, Aluoch LM, Skiles J, Buziba NG, Sitaresmi MN (2014) Influence of health-insurance access and hospital retention policies on childhood cancer treatment in Kenya. Pediatr Blood Cancer 61:913–918
43.
Zurück zum Zitat Martijn HA, Njuguna F, Olbara G, Langat S, Skiles J, Martin S, Vik T, van de Ven PM, Kaspers GJ, Mostert S (2017) Influence of health insurance status on paediatric non-Hodgkin’s lymphoma treatment in Kenya. BMJ Paediatr Open 1:e000149. https://doi.org/10.1136/bmjpo-2017-000149 Martijn HA, Njuguna F, Olbara G, Langat S, Skiles J, Martin S, Vik T, van de Ven PM, Kaspers GJ, Mostert S (2017) Influence of health insurance status on paediatric non-Hodgkin’s lymphoma treatment in Kenya. BMJ Paediatr Open 1:e000149. https://​doi.​org/​10.​1136/​bmjpo-2017-000149
44.
Zurück zum Zitat Parkes J, Hendricks M, Ssenyonga P, Mugamba J, Molyneux E, Schouten-van Meeteren A, Qaddoumi I, Fieggen G, Luna-Fineman S, Howard S, Mitra D, Bouffet E, Davidson A, Bailey S, Siop P (2015) SIOP PODC adapted treatment recommendations for standard-risk medulloblastoma in low and middle income settings. Pediatr Blood Cancer 62:553–564PubMedCrossRef Parkes J, Hendricks M, Ssenyonga P, Mugamba J, Molyneux E, Schouten-van Meeteren A, Qaddoumi I, Fieggen G, Luna-Fineman S, Howard S, Mitra D, Bouffet E, Davidson A, Bailey S, Siop P (2015) SIOP PODC adapted treatment recommendations for standard-risk medulloblastoma in low and middle income settings. Pediatr Blood Cancer 62:553–564PubMedCrossRef
45.
Zurück zum Zitat Hessissen L, Parkes J, Amayiri N, Mushtaq N, Sirachainan N, Anacak Y, Mitra D, Figaji A, Schouten-van Meeteren A, Sullivan M, Burger H, Davidson A, Bouffet E, Bailey S (2017) SIOP PODC adapted treatment guidelines for low grade gliomas in low and middle income settings. Pediatr Blood Cancer 64:e26737CrossRef Hessissen L, Parkes J, Amayiri N, Mushtaq N, Sirachainan N, Anacak Y, Mitra D, Figaji A, Schouten-van Meeteren A, Sullivan M, Burger H, Davidson A, Bouffet E, Bailey S (2017) SIOP PODC adapted treatment guidelines for low grade gliomas in low and middle income settings. Pediatr Blood Cancer 64:e26737CrossRef
46.
Zurück zum Zitat Parkes J, Hess C, Burger H, Anacak Y, Ahern V, Howard SC, Elhassan M, Ahmed S, Ghalibafian M, Abbasi AN, Qureshi BM, Zaghloul M, Zubizarreta E, Bey P, Davidson A, Bouffet E, Esiashvili N (2017) Recommendations for the treatment of children with radiotherapy in low- and middle-income countries (LMIC): a position paper from the pediatric radiation oncology society (PROS-LMIC) and pediatric oncology in developing countries (PODC) working groups of the International Society of Pediatric Oncology (SIOP). Pediatr Blood Cancer 64(Suppl 5) Parkes J, Hess C, Burger H, Anacak Y, Ahern V, Howard SC, Elhassan M, Ahmed S, Ghalibafian M, Abbasi AN, Qureshi BM, Zaghloul M, Zubizarreta E, Bey P, Davidson A, Bouffet E, Esiashvili N (2017) Recommendations for the treatment of children with radiotherapy in low- and middle-income countries (LMIC): a position paper from the pediatric radiation oncology society (PROS-LMIC) and pediatric oncology in developing countries (PODC) working groups of the International Society of Pediatric Oncology (SIOP). Pediatr Blood Cancer 64(Suppl 5)
Metadaten
Titel
Patterns, treatments, and outcomes of pediatric central nervous system tumors in Sudan: a single institution experience
verfasst von
M. Mohammed Ali Elhassan
A. Abdalla Mohamedani
H. Hussein Mohammed Osman
N. Osman Yousif
N. Mohamed Elhaj
I. Qaddoumi
Publikationsdatum
04.01.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 3/2019
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-018-04032-9

Weitere Artikel der Ausgabe 3/2019

Child's Nervous System 3/2019 Zur Ausgabe

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.