Low Survival Rates for Pediatric Patients with Tumor Thrombus in Sarcoma

Area of Science:

• Pediatric Oncology
• Surgical Pathology
• Radiology

Background:

• Tumor thrombus in sarcoma is rare, especially in children, with poorly understood outcomes.
• Adult data suggests a median survival of approximately 14 months, but pediatric data is limited.

Purpose of the Study:

• To investigate the outcomes of pediatric sarcoma patients with tumor thrombus.
• To understand the prognostic factors and survival rates in this specific patient population.

Main Methods:

• Retrospective review of pediatric patients (<18 years) with confirmed sarcoma and tumor thrombus.
• Data collected from 1990-2025 at a single pediatric tertiary center.
• Minimum 3-year follow-up or until end of life, focusing on survival post-tumor thrombus diagnosis.

Main Results:

• Thirteen pediatric patients (median age 10.5 years) were included; osteosarcoma was the most common subtype.
• Overall survival after tumor thrombus diagnosis was 30.8%, with a median survival of 15.2 months post-diagnosis.
• Tumor thrombus was noncontiguous in 38.5% of cases, highlighting the need for advanced imaging.

Conclusions:

• Pediatric sarcoma with tumor thrombus carries a poor prognosis.
• Surgical intervention did not demonstrate long-term survival benefits in this cohort.
• Noncontiguous tumor thrombus requires careful consideration in treatment planning and patient counseling.