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The Outcome of Children With Malignant Bone Tumors: A Single-Center Experience
Mohammadreza Bordbar1, Ali Sarfaraz1, Sezaneh Haghpanah1
1Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Insights
Malignant bone tumors (MBT) are rare in children, primarily affecting adolescent boys. Metastasis significantly worsens outcomes, highlighting the need for early detection and intervention in pediatric oncology.
Area of Science:
- Pediatric Oncology
- Skeletal Oncology
- Cancer Epidemiology
Background:
- Malignant bone tumors (MBT) represent 3-5% of childhood cancers.
- Understanding outcomes in specific geographic regions is crucial for targeted care.
Purpose of the Study:
- To report the 10-year outcomes of pediatric malignant bone tumors in Southern Iran.
- To identify prognostic factors for survival in this cohort.
Main Methods:
- Retrospective analysis of 100 pediatric MBT patients diagnosed over 10 years.
- Evaluation of patient demographics, tumor types (Osteosarcoma, Ewing sarcoma), metastasis rates, and survival data.
Main Results:
- The cohort comprised 57 Osteosarcoma and 43 Ewing sarcoma cases, with a male predominance (M/F ratio 1.56) and median age of 13.8 years.
- Metastasis occurred in 27% of patients, predominantly within 3 months of diagnosis.
- The 5-year overall survival was 85.2%, and event-free survival was 69.2%. Metastasis was the sole independent predictor of mortality (HR 36.7, P=.001).
Conclusions:
- Malignant bone tumors in children predominantly affect adolescent males.
- A significant proportion (one-third) develop metastasis, strongly correlating with poor prognosis.
- Metastasis is a critical determinant of survival in pediatric malignant bone tumors.
Abstract:
Malignant bone tumors (MBT) account for 3% to 5% of cancers in children younger than 15 years. We aimed to report the outcome of children with MBT in 10 years in Southern Iran. During the study period, 100 patients (57 Osteosarcoma, 43 Ewing sarcoma) with an M/F ratio of 1.56 and a median age of 13.8 years (3.8-17.9) were diagnosed. Metastasis occurred in 27% of patients, mostly in the first 3 months of diagnosis. The mean survival time of MBT altogether was 94.1 months (95% CI: 86.5-101.7). The 5-year overall survival and event-free survivals were 85.2% (95% CI: 74%-91.8%) and 69.2% (95% CI: 56%-79%), respectively. Metastasis was the only independent risk factor of death in our study cohort (Hazard ratio 36.7, 95% CI: 4.8-282.6, P = .001) MBT in children mostly occur in adolescent boys. About one-third of them become metastatic, which is significantly associated with poor outcomes.
