Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in pediatric population and adolescents. Limited data is available on the characteristics of RMS in Iraqi pediatric patients. The aim of the study was to examine the clinical and histological aspects of RMS in Iraqi children, with a focus on their response to treatment, prognosis, and survival. A retrospective cohort study was conducted at the Oncology Unit of Children's Welfare Teaching Hospital, Medical City, Baghdad, Iraq and included patients who were newly diagnosed with RMS and received treatment during the period between January 1, 2015, and December 31, 2019. The patients were followed up from the time of diagnosis until October 1, 2020. A total of 59 patients were included with a median age of 3.5 years ranging between 1-12 years, with a male-to-female ratio of 3.2:1. The most frequent clinical presentation was urine retention in 15 patients (25.4%), followed by proptosis in 14 (23.7%) patients. However, the main sites of involvement were the head and neck in 23 (39%) patients, followed by the trunk and the genitourinary tract observed in 17 (28.8%) and 15 (25.4%) patients, respectively. The alveolar type, found in 11 (18.7%) patients, was the most prevalent histological variety, followed by the embryonal type reported in 42 (71.3%) patients, whereas six patients (9.7%) had other varieties. Of the 49 patients included in the prognosis assessment, 18 patients (36.7%) had a complete response, 20 patients (40.8%) died, and 11 patients abandoned treatment. The average duration of disease recurrence was 21.3 months, with a 7% recurrence rate. The overall survival rate was 36.7%, with a mean survival duration of 14.1 months. Pediatric RMS in Iraq is primarily prevalent in males. There is a significant delay in disease diagnosis from the onset of the symptoms. A high rate of advanced-stage disease may relate to patients reluctant to discontinue treatment. The low disease-free survival rate is due to impediments that hindered the effectiveness of therapy.
References
1.
Munnikhuysen SR, Ekpo PA, Xue W, Gao Z, Lupo PJ, Venkatramani R, et al. Impact of race and ethnicity on presentation and outcomes of patients treated on rhabdomyosarcoma clinical trials: A report from the Children’s Oncology Group. Cancer Medicine. 2023;12(11):12777–91.
2.
M LP. Manual of pediatrics hematology and oncology. 2011;
3.
Rodary C, Rey A, Olive D, Flamant F, Quintana E, Brunat‐Mentigny M, et al. Prognostic factors in 281 children with nonmetastatic rhabdomyosarcoma (RMS) at diagnosis. Medical and Pediatric Oncology. 1988;16(2):71–7.
4.
Hatam DA, Al-Janabi ANH, AL-Harris SSAZ. Pediatric Rhabdomyosarcoma in Child’s Central Teaching Hospital. Mustansiriya Medical Journal. 2022;21(1):53–8.
Antillon F, Castellanos M, Valverde P, Luna‐Fineman S, Garrido C, Serrato T, et al. Treating Pediatric soft tissue sarcomas in a country with limited resources: The experience of the Unidad Nacional de Oncologia Pediatrica in Guatemala. Pediatric Blood & Cancer. 2008;51(6):760–4.
7.
Warwick AB, Dome JS. Chapter 24 - Renal tumors. In: Lanzkowsky’s Manual of Pediatric Hematology and Oncology. 2022. p. 525–40.
8.
Unuvar A, Celik A, Gedikoglu G. Results of rhabdomyosarcoma treatment in a developing country. Acta Med Okayama. 2000;54:173–7.
9.
Kadhim AM. Rhabdomyosarcoma In Iraqi children. 2005;
10.
Baker KS, Anderson JR, Lobe TE, Wharam MD, Qualman SJ, Raney RB, et al. Children From Ethnic Minorities Have Benefited Equally as Other Children From Contemporary Therapy for Rhabdomyosarcoma: A Report From the Intergroup Rhabdomyosarcoma Study Group. Journal of Clinical Oncology. 2002;20(22):4428–33.
11.
Ward E, DeSantis C, Robbins A, Kohler B, Jemal A. Childhood and adolescent cancer statistics, 2014. CA: A Cancer Journal for Clinicians. 2014;64(2):83–103.
12.
Siegel DA, King J, Tai E, Buchanan N, Ajani UA, Li J. Cancer Incidence Rates and Trends Among Children and Adolescents in the United States, 2001–2009. Pediatrics. 2014;134(4):e945–55.
13.
McDowell HP, Foot ABM, Ellershaw C, Machin D, Giraud C, Bergeron C. Outcomes in paediatric metastatic rhabdomyosarcoma: Results of The International Society of Paediatric Oncology (SIOP) study MMT-98. European Journal of Cancer. 2010;46(9):1588–95.
14.
Crane JN, Xue W, Qumseya A, Gao Z, Arndt CAS, Donaldson SS, et al. Clinical group and modified TNM stage for rhabdomyosarcoma: A review from the Children’s Oncology Group. Pediatric Blood & Cancer. 2022;69(6).
15.
Ro I. Environment MoHa. 2020.
16.
Stiller C, McKinney P, Bunch K, Bailey C, Lewis I. Childhood cancer and ethnic group in Britain: a United Kingdom children’s Cancer Study Group (UKCCSG) study. British Journal of Cancer. 1991;64(3):543–8.
17.
Stiller CA, Parkint DM. International variations in the incidence of childhood soft‐tissue sarcomas. Paediatric and Perinatal Epidemiology. 1994;8(1):107–19.
18.
Pastore G, Peris-Bonet R, Carli M, Martínez-García C, de Toledo JS, Steliarova-Foucher E. Childhood soft tissue sarcomas incidence and survival in European children (1978–1997): Report from the Automated Childhood Cancer Information System project. European Journal of Cancer. 2006;42(13):2136–49.
19.
Perez EA, Kassira N, Cheung MC, Koniaris LG, Neville HL, Sola JE. Rhabdomyosarcoma in Children: A SEER Population Based Study. Journal of Surgical Research. 2011;170(2):e243–51.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
