Diagnostic Delay and Survival in Pediatric Rhabdomyosarcoma: Is Time a Critical Factor?

Area of Science:

• Pediatric Oncology
• Cancer Research
• Clinical Epidemiology

Background:

• Timely diagnosis is crucial in pediatric oncology for optimizing treatment outcomes.
• Delays in diagnosis for pediatric rhabdomyosarcoma (RMS) may negatively affect tumor extension and prognosis.
• Assessing trends in diagnostic and treatment intervals for RMS is important for improving patient care.

Purpose of the Study:

• To evaluate if the time to diagnosis and treatment initiation for pediatric RMS patients in Italy has improved over time.
• To determine if longer diagnostic delays are associated with tumor characteristics and prognosis in pediatric RMS.
• To analyze the impact of diagnostic and treatment intervals on survival outcomes for children with RMS.

Main Methods:

• Analysis of 749 pediatric patients diagnosed with RMS between 1996 and 2016.
• Definition of diagnostic interval (DI) as symptom onset to diagnosis, and treatment interval (TI) as symptom onset to treatment initiation.
• Correlation of DI with tumor characteristics and analysis of TI in relation to survival using Kaplan-Meier analysis.

Main Results:

• Median DI decreased from 39.5 days (1996-2000) to 30 days (2011-2016).
• Longer DI was associated with age, unfavorable histology, and metastatic disease in univariate analysis, but not confirmed in multivariate analysis.
• Prognosis was negatively associated with age, unfavorable site, nodal involvement, and metastatic disease; TI did not impact survival.

Conclusions:

• The time from symptom onset to diagnosis for pediatric RMS shows a trend toward shortening in recent years.
• While timely diagnosis provides clarity and may reduce parental anxiety, it does not substantially impact tumor characteristics or patient outcomes.
• Factors like age at diagnosis, tumor site, nodal involvement, and metastatic disease are key prognostic indicators in pediatric RMS.