Pediatric rhabdomyosarcoma in child's central teaching hospital: An eight-year experience

Abstract

Background: Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in the first two decades of life. There is, however, a paucity of reports on the pattern of its occurrence in Iraq. Aim: To determine the demographic characteristics, clinical presentation, and survival among children with RMS treated at Child's Central Teaching Hospital (CCTH). Patients and Methods: A retrospective study was on 48 patients of histologically proven. RMS, in previously untreated children aged <15 years old at the CCTH in Baghdad, during the period from January 2009 to December, 2017. Results: Forty-eight patients with confirmed RMS were included. The mean age (standard deviation) was 4.9 (3.5) years. Thirty-four patients (70.8%) were <6 years, male 22 patients (46.8%), female 26 patients (54.2%), male:female ratio of approximately 1:1.2. Histopathology was embryonal in 38 case (79.1%). Incisional biopsy was done in 21 patients (43.8%), while excisional biopsy in 18 (37.5%) patients. The head and neck was the most common site of involvement at presentation, (nonorbital) 16 (33.3%) of cases. The estimated 4-year event-free survival (EFS) was 26.3% ± 7%. Twenty-one (43.8%) patients abandoned treatment. Among the cases who completed their treatment in the center, eight cases (16.7%) relapsed. In univariate analysis using log-rank test, nodal involvement was found to significantly influence the EFS at 4 years (P = 0.01). The estimated 4-year overall survival was 41.4% ± 9%. Nodal involvement significantly reduces overall survival at 4 years (P = 0.006). Conclusions: Clinical features and epidemiology of RMS in Iraqi children treated at CCTH somewhat resembles those of other countries. However, the EFS at 4 years and overall survival at 4-years are lower than that reported elsewhere.