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Malignant abdominal tumors in children
1Department of Surgery, Robert C Byrd HSCN, West Virginia University Hospital, Morgantown 26506-9238, USA.
Insights
Early diagnosis and multimodality treatment significantly improve survival rates for childhood abdominal malignancies. This study highlights the importance of timely medical attention for conditions like Wilms' tumor in pediatric patients.
Area of Science:
- Pediatric Oncology
- Surgical Pathology
- Medical Imaging
Background:
- Malignant abdominal tumors are a significant concern in pediatric populations.
- Wilms' tumor is the most prevalent childhood abdominal malignancy.
- Understanding the demographics and outcomes of these tumors is crucial for improving patient care.
Purpose of the Study:
- To review the characteristics and outcomes of malignant abdominal tumors in children.
- To analyze the presentation, diagnosis, and treatment of Wilms' tumor.
- To assess the survival rates and recurrence of childhood abdominal malignancies.
Main Methods:
- Retrospective review of 53 pediatric patients (ages 1-18) with malignant abdominal tumors diagnosed between 1987 and 1993.
- Analysis of tumor types, patient demographics, clinical presentation, diagnostic methods (ultrasonography, CT scan), and treatment modalities (surgery, chemotherapy).
- Evaluation of treatment outcomes, including survival rates and recurrence, specifically for Wilms' tumor.
Main Results:
- Wilms' tumor represented 28.3% of cases, followed by Non-Hodgkin's lymphomas (20.8%) and neuroblastomas (11.3%).
- The majority of patients (60.3%) were under 5 years old, with a 1:1 male to female ratio.
- Patients with Stage III Wilms' tumor often presented late (>1 month from symptom onset), whereas those with Stage I/II presented earlier.
- A 93.3% survival rate was observed for Wilms' tumor with no recurrences after a mean follow-up of 1 year and 9 months.
Conclusions:
- Timely diagnosis and prompt treatment initiation are critical for improving outcomes in pediatric abdominal malignancies.
- Multimodality treatment, including surgery and chemotherapy, is effective in managing these aggressive tumors.
- Improved survival rates for childhood malignancies are achievable with early detection and comprehensive care strategies.
Abstract:
The medical records of 53 patients between the ages of 1 and 18 years, with malignant abdominal tumors seen between 1987 and 1993 were reviewed. Wilms' tumor was the most common tumor constituting 28.3% of all cases. The others included Non- Hodgkin's lymphomas (20.8%), neuroblastomas (11.3%), rhabdomyosarcomas, germ cell tumors 9.4% each and a miscellaneous group. Majority of patients (60.3%) were under 5 years of age. The male to female ratio was 1:1. Among 15 patients with Wilms' tumor, majority (46.7%) had stage III tumors at presentation and all but one patient, were referred to our Hospital more than a month following initiation of their symptoms. In contrast, 5 out of 7 patients with Stage I and II tumors were seen within the first month of their symptoms. The commonly utilized techniques to aid diagnosis were ultrasonography and computerized tomography scan and the common treatment modality was a combination of surgery and chemotherapy. For Wilms' tumor, the mean follow-up was 1 year and nine months, the survival rate was 93.3% and there were no recurrences. With early diagnosis and multimodality treatment, the survival rates for childhood malignancies can be greatly improved.
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