The burden of pediatric malignant solid tumors in a developing country.

OBJECTIVE This study evaluates the burden of pediatric malignant solid tumors (PMST) in southeastern Nigeria. METHODS Analysis of 174 cases of PMST managed at the University of Nigeria Teaching Hospital Enugu, from January 2002 to November 2007. RESULTS PMST comprised 2.8% of pediatric admissions. Tumors encountered were lymphomas 77 (44.3%), Wilms' tumor 35 (20.1%), sarcomas 20 (11.5%), neuroblastoma 15 (8.6%), retinoblastoma 14 (8.0%), teratomas 8 (4.6%) and hepatoma 5 (2.9%). Mean time for diagnosis was 3.3 +/- 2.4 months. Advanced disease occurred in 135 (77.6%), while 39 (22.4%) had early disease. Only 166 (95.4%) commenced planned therapy, with 67 (40.4%) lost to follow-up. Of 99 children available for evaluation, 43 died (11 treatment related and 32 from relapse). Overall, 56 (56.6%) were alive after a mean follow-up of 20.7 +/- 10.5 months. CONCLUSION PMST are enormous challenge in our setting. Delayed presentation, poor treatment compliance and healthcare funding have to be addressed to improve outcomes.