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Published on: February 22, 2015
[Malignant solid tumors in neonates: a study of 71 cases]
C de Bouyn-Icher1, V Minard-Colin, A Isapof
1Service d'Oncologie Pédiatrique, Institut Gustave-Roussy, rue Camille-Desmoulins, 94805 Villejuif cedex, France. icher@igr.fr
Summary
Malignant neonatal tumors are rare but generally have a good prognosis with appropriate treatment. Expert management, including reduced-dose chemotherapy and surgery, is key to improving survival and minimizing long-term side effects in infants.
Area of Science:
- Pediatric Oncology
- Neonatal Medicine
- Cancer Research
Background:
- Malignant neonatal tumors are rare, accounting for 2% of childhood cancers.
- These tumors present unique diagnostic, therapeutic, and ethical challenges due to distinct clinical features and prognoses compared to older children.
- Neonatal solid tumors require specialized management strategies.
Purpose of the Study:
- To review the management and outcomes of neonates diagnosed with malignant solid tumors.
- To evaluate the efficacy and safety of various treatment modalities in this specific population.
- To identify factors influencing prognosis and long-term sequelae.
Main Methods:
- Retrospective study of 71 neonates treated for malignant solid tumors between January 1987 and January 2004.
- Analysis of tumor types, treatment interventions (surgery, chemotherapy, radiotherapy), complications, and survival rates.
- Review of sequelae in survivors.
Main Results:
- Neuroblastomas were the most common type (59%), followed by mesenchymal and cerebral tumors.
- Surgery was performed in 59 patients; chemotherapy (30-50% reduced dose) in 38.
- The 5-year overall survival rate was 79%, with no therapy-related mortality. Sequelae were observed in 22 survivors.
Conclusions:
- Neonatal malignant solid tumors, excluding cerebral tumors, exhibit a favorable prognosis.
- Treatment tolerance in neonates is a significant concern, necessitating careful consideration of iatrogenic toxicity and long-term sequelae.
- While surgery is primary, dose-reduced chemotherapy by expert teams is crucial and often safer for managing these rare cancers.