ABSTRACT
Few reports on clinical factors, treatment, and survival in children and adolescents with Central nervous system tumors in low-income and middle-income countries in Latin America exist. We retrospectively reviewed such data in all cases of patients younger than 18 years with brain tumors diagnosed in a single tertiary care center in Peru from 2007 through 2017. Variables were analyzed for association with overall survival and event-free survival by using the Kaplan-Meier method and the Cox hazards ratio regression. Seventy-five patients' data were analyzed (40 boys, 35 girls; mean age=7.7 y). The main clinical symptoms were headache, vomiting, difficulty walking, and visual disturbances. The most frequent clinical signs were hydrocephalus, cerebellar signs, visual abnormalities, and focal motor signs. The median time to diagnosis was 12 weeks. Tumor resection was performed in 68 patients, and 37 patients received postoperative radiotherapy. The most frequent histologic subtypes were low-grade gliomas and medulloblastomas. Overall survival rates at 1 and 5 years of disease were 78% (CI 95%, 0.67 to 0.86) and 74% (CI 95%, 0.62 to 0.82), respectively, and the 5-year event-free survival rate was 62% (CI 95%, 0.47 to 0.73). Although diagnosis occurred late in our cohort, the survival rate was higher than that in other Latin American countries.
Subject(s)
Central Nervous System Neoplasms , Cerebellar Neoplasms , Medulloblastoma , Child , Male , Adolescent , Female , Humans , Retrospective Studies , Peru/epidemiology , Medulloblastoma/therapy , Central Nervous System Neoplasms/epidemiology , Central Nervous System Neoplasms/therapy , Cerebellar Neoplasms/therapyABSTRACT
Antecedentes: Los tumores testiculares en Pediatría son el 2 por ciento de los tumores sólidos malignos. El objetivo de este estudio fue evaluar las caracteristicas de la enfermedad y los resutados del tratamiento en niños con tumor de células Germinales Malignos (TCGM) de testículos. Métodos. Los pacientes diagnosticados y tratados de TCGM de testículo entre enero de 2000 a diciembre de 2007 fueron analizados retrospectivamente. Resultados: 14 pacientes fueron diagnosticados de TCGM testícular durante este periodo. La edad promedio fue de 15.3 meses (rango 4-33). La cirugía fue realizada en 11 (78.9 por ciento) pacientes en otra institución y la información quirúrgica no fue obtenida. El testículo derecho estaba comprometido en 10 (71,4 por ciento) pacientes. Todos los pacientes tuvieron orquitectomía inguinal y el tiempo medio hasta el inicio de quimioterapia fue de 73,2 días. La AFP al diagnóstico se obtuvo en 8 (57,1 por ciento) pacientes y el promedio de AFP fue 6437.6 mg/mL (rango 345.3-32962.0). De acuerdo al sistema de estadiaje de la POG/CCG, 9 pacientes fueron estadio 1(64,3 por ciento); 4 (28,6 por ciento), estadio II; y 1(7,1 por ciento), estadio III. El diagnóstico histopotológico fue tumor del seno endodermal en 11(78,6 por ciento) mixto en 2 (14,3 por ciento) y carcinoma embrionario en 1(7,1 por ciento), 8(57,1 por ciento) pacientes fueron fueron tratados con Bleomicina, Etoposido y Cisplatino, 4 (28,6 por ciento) con Etoposido, Ifosfamida y Cisplatino y 2 (14,3 por ciento) con Vinblastina, Bleomicina y Cisplatina; 11 (78,6 por ciento) alcanzaron respuestas completa y 3 (21,4 por ciento) respuesta parcial. Todos los pacientes recibieron como mínimo 6 ciclos de terapia con 21 días de intervalo, excepto los pacientes con respuesta parcial. El tiempo promedio de seguimiento fue de 49,5 meses (rango 5-92) y todos estan vivos y ninguno ha recaído. Conclusiones. Las características clínicas encontradas son similares a la de la literatura. A pesar...
Background: Pediatric testicular tumors are rare, accounting for 2 per cent of solid malignant neoplasm. The aim of this study was to evaluate disease characteristics, treament result and outcome of children with testicular malignant germ cell tumor (TCGM) from testes. Methods. The patients who where diagnosed and treated of testicular TCGM between January 2005 and December 2007 were analyzed retrospectively. Results: Fourteen newly diagnosed testicular TCGM were seen during this period. The median age was 15.3 months (range 4-33). The surgery was carried out in 11 (78.9 per cent) patients in other institutions and surgical information was not available. The right testicular involved was in 10(71.4 per cent) patients. All patients underwent an initial inguinal orchiectomy until beginning the chemotherapy was 73.2 days. The AFP at diagnosis was available in 8 (57.1 per cent) patients and the median AFP was 6437.6 mg / mL (range 345.3-32962.0). According to the POG/CCG staging system, 9(64,3 per cent) were stage 1,4 (28,6 per cent) stage II, and 1 (7.1 per cent), stage III. Histopotológico diagnoses were yolc sac tumor in 11 (78.6 per cent) mixed in 2 (14.3 per cent) and embryonal carcinoma in 1 (7.1 per cent), 8 (57.1 per cent) patients were treated with bleomycin , etoposide and cisplatin, 4 (28.6 per cent) with etoposide, ifosfamide and cisplatin and 2 (14.3 per cent) with Vinblastine, bleomycin, and cisplatin, 11 (78.6 per cent) achieved complete responses and 3 (21.4 per cent ) partial response. All patients received at least 6 cycles of therapy with 21 days apart, except for patients with partial response. The average follow-up time was 49.5 months (range 5-92) and all are alive and none are relapsed. Conclusions. Even though this small study with short follow up the testicular TCGM patitents has better suvival.
Subject(s)
Male , Humans , Infant, Newborn , Infant , Child, Preschool , Child , Neoplasms, Germ Cell and Embryonal , Neoplasms, Germ Cell and Embryonal/diagnosis , Neoplasms, Germ Cell and Embryonal/epidemiology , Neoplasms, Germ Cell and Embryonal/therapy , Prognosis , Testis , Retrospective StudiesABSTRACT
Los tumores de Ovario en niñas constituyen 1 por ciento de los tumores en niñas de 18 años. En el presente estudio evaluamos las características clínicas más frecuentes como forma de presentación, grupo etáreo, tipo histológico y tratamiento. Evaluamos restrospectivamente a pacientes pediatricos de sexo femenino con Cáncer de Ovario desde enero de 1996 a abril del 2008. De un total de 1,188 pacientes pediátricos con Cáncer, evaluados durante el periodo de enero de 1996 a abril d e2008, tenemos acumulados a la fecha 20 casos de niñas con Cáncer de Ovario. El cuadro clínico más frecuente es el dolor pélvico (100 por ciento), seguido de tumor palpable (95 por ciento). El tipo histológico más frecuente es el Teratoma Inmaduro (35 por ciento), Disgerminoma (30 por ciento) Cistoadenoma mucinoso (15 por ciento), Carcinoma Embrionario (5 por ciento) y Mixto (15 por ciento). Todos los casos de niñas con Cancer de Ovario (100 por ciento) fueron operadas con citoreducción primaria, seguido de quimioterapia adyuvante con Etoposido, Cisplatino e Ifosfamida y como manejo de segundo línea Bleomicina. Doxorrubiccina y Carboplatino (5 por ciento). En la actualidad tenemos 15 (75 por ciento) pacientes pediátricos y adolescentes con Cancer de Ovario, libres de enfermedad.
The tumors of ovary in female children constitute the 1 per cent of the tumors in less tham 18 year. In the present study we evaluated clinical characteristics as initial presentation, age group, histological type and treatment. We evaluated retrospectively female pediatric patients with ovarian cancer from January 1996 to April 2008. Of total 1.188 pediatric patients with cancer, we have accumulated 20 cases of female children's with ovarian cancer. The clincal presentation was pelvic pain (100 per cent), followed by palpable tumor (95 per cent). The histological type was Immature teratoma (35 per cent) Dysgerminoma (30 per cent) mucinous cystadenoma (15 per cent), embryonal carcinoma (5 per cent) and Mixed (15 per cent). All the cases of female children with ovarian cancer (100 per cent) were operated initially with primary cytoreduction followed by adjuvant chemotherapy with etoposide, cisplatin and ifosfamide and as managementwith second line of chemoterapy bleomicin. Doxorrubiccina and Carboplatin (5 per cent). We have 15 (75 per cent) female pediatric patients and and adolescent with ovarian cancer, disease-free of illness.
