Current status and future perspective of pediatric malignancy in Kyushu and Okinawa regions

Abstract

A pediatric malignancy is a representative “rare cancer”, with a yearly incidence of only 2,000. Therefore, it is reasonable to consolidate clinical expertise in “centers of excellence” where pediatric patients can be treated appropriately. Acute lymphoblastic leukemia is the most common pediatric malignancy, and there is little disparity in treatment outcomes between facilities because of the remarkable progress in treatment, making it a representative disease for which standardization is important. Thus, while consolidation is generally necessary for pediatric malignancies, standardization is particularly important in certain cases. In the Kyushu and Okinawa regions, cooperation between facilities in each prefecture and Kyushu University Hospital as a core hospital has been established. A facility can become a Japanese pediatric hematology and oncology specialist training facility via two routes: becoming an affiliate of Kyushu University Hospital or becoming an independent parent facility, for which certified instructors in pediatric hematology and oncology and certified surgeons for pediatric malignancies are required. Furthermore, a certain number of new patients with pediatric malignancy annually is necessary. There are only two independent facilities in the Kyushu and Okinawa regions, each able to discuss cases that are difficult to deal with and share information through monthly web conferencing systems. There are no difficulties in daily practice, although the successful training of certified instructors and surgeons is necessary to increase the number of independent facilities for the management of pediatric malignancies.