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[Malignant pelvic neoplasms in children treated in two Polish oncology centres]
Teresa Stachowicz-Stencel1, Ewa Bień, Joanna Zawitkowska-Klaczyńska
1Klinika Pediatrii, Hematologii, Onkologii i Endokrynologii, Akademia Medyczna, Debinki 7, 80-211 Gdańsk, Poland. tsten@amg.gda.pl
Insights
Radical tumor resection is crucial for treating pediatric pelvic cancers. Complete removal offers the best chance for remission, especially for germ cell tumors (TGM) and soft tissue sarcomas (MTM).
Area of Science:
- Pediatric Oncology
- Surgical Oncology
- Pediatric Hematology
Context:
- Malignant neoplasms in the pediatric pelvis present significant diagnostic and therapeutic challenges.
- This study focuses on children diagnosed with primary malignant pelvic tumors.
Purpose:
- To evaluate clinical symptoms, disease progression, and treatment outcomes for pediatric patients with malignant pelvic neoplasms.
- To identify prognostic factors influencing survival in this patient cohort.
Summary:
- The study analyzed 31 children (aged 2 months to 16 years) with pelvic malignancies, including soft tissue sarcomas (MTM), germ cell tumors (TGM), and neuroblastoma (NBL).
- Most patients (90%) presented with advanced disease (Stages III-IV).
- Radical tumor resection, particularly primary resection, was identified as a critical factor for successful treatment, achieving remission in all cases where it was performed.
Impact:
- Effective surgical management, especially primary radical resection, significantly improves outcomes for pediatric pelvic malignancies.
- Patients unable to undergo complete tumor resection faced disease progression and unfavorable prognoses.
- Findings highlight the importance of early and complete surgical intervention in pediatric oncology for pelvic tumors.
Background:
Extensive diagnostic and therapeutic dilemmas appear in children With primary malignant neoplasms located in the minor pelvis.
The Aim Of The Study:
To evaluate the clinical symptoms, disease course and the results of treatment in patients with malignant pelvic neoplasms.
Material And Methods:
The study included 31 children (13 boys and 18 girls; aged 2 months to 16 years; mean age -- 8 years) treated in the Departments of Paediatric Oncology and Haematology in Gdansk and Lublin during the period of 1992-2003. The group comprised 17 patients with soft tissue sarcomas (MTM) (55%), 12 with germinal tumours (TGM) (39%) and tow. with neuroblastoma (NBL) (6%). The great majority of children (90%) presented with highly advanced disease (stages III + IV -- in 28 out of 31 patients).
Results:
with data analysis we were able to distinguish two categories of patients with different prognosis: with MTM and TGM. Most of he MTM tumours (11/17 - 65%) were localized in the urinary tract, the remaining six developed within pelvic muscles. Ten out of twelve TGM tumours (83%) were located in the ovaries. Radical tumour resection, especially primary resection, was shown to play the key role in both groups. Among TGM patients it was performed in 75% while in MTM patients -- in only 12%. All of these patients entered clinical remission and remain disease free. After adjuvant chemo- and/or radiotherapy secondary tumour resection was done in 17% of TGM and 41% of MTM patients.
Conclusion:
in patients, who were not able to undergo radical tumour resection (mainly MTM patients), the disease progressed and led to death.