Delay in diagnosis of children with cancer: a retrospective study of 315 children.

To determine the demographic and systemic parameters in children with solid malignancies and to ascertain which of them affected the delay in diagnosis, a retrospective study was performed on 315 children diagnosed with a solid tumor at our hospital, including epidemiological, social, and medical issues concerning the family, the child, the medical system, and the tumor. Lag time, defined as the interval between onset of symptoms and final diagnosis, including parent delay and physician delay, was estimated for each child. Mean lag time: 15.75 weeks (w), median: 7 w, range: 0-208 w. Lowest mean values appeared in kidney tumors, highest in epithelial, brain and soft tissue sarcomas. Mean parent delay: 4.42 w, median: 1 w, range: 0-130 w. Mean physician delay: 11.17 w, median: 4 w, range: 0-206 w. Among the demographic and personal parameters, the best predictors for diagnosis delay were age of child and father's ethnic origin. Several factors influenced diagnosis delay of childhood solid tumors. Recognizing these factors could minimize the delay, thereby improving the child's chances of survival.

[Hodgkin's disease in childhood--northern Israel cancer center experience, 1971-1990].

Records of children treated for Hodgkin's disease between 1971-1990 were analyzed retrospectively, and 102 cases of children younger than 18 years when diagnosed were reviewed. There were 54 boys and 48 girls, with male predominance in those younger than 10 years. 44 patients were of Arab ancestry and 58 were Jewish; the incidence was similar in both groups. Most common were the nodular sclerosing and mixed cellularity types, the latter more common in the younger age group. The outcome of various treatments was evaluated. At diagnosis, 64% were in stages I or II and 34% in stages III or IV. 20 of those in stages I-II received radiotherapy (RT) alone, 10 chemotherapy (CT) alone, and 35 combined CT and RT. Survival rates and median disease-free intervals were statistically similar with all 3 modalities. However, relapse rates were higher with either RT or CT alone (35% and 38%, respectively) than with combined therapy (14%). We conclude that combined CT and RT is superior to RT or CT alone.

[Abdominal malignancies in childhood].

We reviewed epidemiological data and outcome of 134 children with abdominal tumors (AT) among a total of 460 children with solid tumors (ST) seen between 1971-1989. There were no significant differences in ethnic distribution or sex ratio between children with AT and ST. The mean age was younger in those with AT than with ST (4.7 vs 7.2 years). The 3 major histologic AT types were Burkitt lymphoma, Wilms' tumor and neuroblastoma, with a relative increase after 1978 in those with abdominal Burkitt lymphoma. A comparison of our therapeutic results in AT treated before and after 1981 shows significant improvement in the actuarial survival at 5 years: 71.1% of those treated after 1981 were then alive with no evidence of disease, vs only 32.8% of those treated before 1981. Since 1981 the actuarial survival at 5 years in our children with Wilms' tumor and abdominal Burkitt lymphoma is about 80%.