Pediatric Rhabdomyosarcoma in India: A Single-center Experience
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Published on: October 14, 2016
Deepak Bansal1, Anirban Das, Amita Trehan
1Pediatric Hematology/Oncology unit, Advanced Pediatrics Center, *Department of Radiotherapy, #Otolaryngology, $Cytology, ‡Histopathology, ^Radiodiagnosis, and **Pediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Correspondence to: Dr Deepak Bansal. Professor, Hematology-Oncology unit, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India. deepakbansaldr@gmail.com.
Insights
Large tumors, unfavorable locations, and treatment abandonment negatively impact outcomes for pediatric rhabdomyosarcoma patients. Improving treatment adherence is crucial for better survival rates in children with this rare cancer.
Area of Science:
- Pediatric Oncology
- Pediatric Cancer Research
- Rhabdomyosarcoma Epidemiology
Background:
- Rhabdomyosarcoma is a rare pediatric cancer requiring comprehensive analysis.
- Understanding treatment challenges and outcomes is vital for improving patient care.
Purpose of the Study:
- To analyze the clinical profile and outcomes of children diagnosed with rhabdomyosarcoma.
- To identify factors influencing survival in pediatric rhabdomyosarcoma patients.
Main Methods:
- Retrospective analysis of 159 children (<12 years) with rhabdomyosarcoma over 23 years (1990-2012).
- Data collected from a tertiary-care university hospital in Northern India.
- Outcomes assessed using five-year event-free survival.
Main Results:
- Head and neck (44%) and extremity (15.7%) were common tumor sites.
- Most tumors were large (>5 cm, 68%) and in unfavorable locations (67%).
- Five-year event-free survival was 43.6 ± 6% for treated patients, with significant treatment refusal (18%) and abandonment (33%).
Conclusions:
- Tumor size, unfavorable location, and treatment abandonment significantly worsen outcomes.
- Addressing barriers to treatment adherence is critical for improving survival in pediatric rhabdomyosarcoma.
Objective:
Analyze the profile and outcome of children with rhabdomyosarcoma from a pediatric-oncology unit.
Design:
Retrospective analysis of case records over 23 years (1990-2012).
Setting:
Government-run, tertiary-care, university hospital in Northern India.
Participants:
159 children (<12-years) with a diagnosis of rhabdomyosarcoma were enrolled. The median age was 4 years; 13% were infants.
Main Outcome Measure:
Five-year event free survival.
Results:
The median symptom interval was 2-months. Head and neck region was the most frequent site (44%), followed by tumors in the extremity (15.7%). The majority (67%) of the tumors were located at 'unfavorable' sites; 68% were >5 cm in size. The most frequent (58%) pathological subtype was embryonal. Treatment was based on the 'Intergroup Rhabdomyosarcoma Study (IRS) Group' risk-stratification. 33% were 'low-risk' children, 11% were 'high-risk'. Treatment-refusal (18%) and abandonment (33%) were major impediments. The median ± SE five-year event free survival of those taking treatment was 43.6 ± 6%.
Conclusion:
Large sized tumors, tumors at unfavorable locations, and treatment refusal/abandonment contributed to inferior outcome in children with rhabdomyosarcoma.
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