RESUMEN
Treatment of children with cancer is one of the most complex problems in pediatric practice which should begin with early detection and proper evaluation. To study the main clinico-epidemiological features of children with solid tumors diagnosed and treated at the Pediatric Hematology/ Oncology Unit, Ain Shams University during the last three decades. This is a retrospective study to analyze the clinical and epidemiological features of children diagnosed with solid tumors during the period between January 1st, 1975 till December 3 1st, 2005. All patients and their files were revised for demographic features, initial presentation, disease staging, histopathologic grading, changing pattern of each tumor, frequency of relapses, morbidity/mortality, response to therapy, and outcome. During the last three decades 287 patients with pediatric solid tumors were diagnosed at the Pediatric Hematology/ Oncology Unit, Children's Hospital, Ain Shams University. They represented 29.9% of all childhood neoplasm diagnosed during that period. Neuroblastoma was the commonest solid tumor [40.4%] with a male to female ratio of 1.31 and a mean age of 31.8 months. Abdominal mass, mediastinal disease, multiple bone lesions, progressive weight loss and proptosis were the presenting symptoms in this order of frequency, with two thirds of patients presented with advanced disease stage [stage III and IV]. Wilms' tumor represented 22.9% of all pediatric solid tumors with a male to female ratio of 1:1 and a mean age of 53.23 months, with 93% of patients presented with abdominal swelling and 59% had advanced disease stage [stage III and IV]. Rhabdomyosarcoma was diagnosed in 11.8% of patients with a male to female ratio of 1.6 to 1. Abdominal involvement and head and neck were the most common sites of affection. Other less frequent tumors included histiocytosis [11.1% of cases], malignant bone tumors [10.4% of cases] and hepatoblastoma [3.4% of cases]. Fever and sepsis were the most common treatment related morbidity. Five-year survival rate was steadily improving over the last 30 years. Pediatric solid tumors constituted 29.9% of all tumors diagnosed at the Pediatric Hematology/Oncology Unit, Ain Shams University during the last three decades. Neuroblastoma was the commonest tumor [40.4%] followed by Wilms' tumor [22.9%] and rhabdomyosarcoma [11.8%]. Most of patients with solid tumor [71% of patients with neruoblastoma, 59% of patients with WiIms' tumor and 64% of patients with rhabdomyosarcoma] presented with advanced disease stage [III and IV]. Sepsis and myelosuppression were the commonest complications. The mortality rate improved significantly for all tumors over the last three decades. Finally, a national registry of childhood cancer is mandatory and multicenter studies are strongly advised to be considered