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Pediatric Rhabdomyosarcoma in India: A Single-center Experience
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.
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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