Malignant bone tumors in pediatric age groups in Iraq

Abstract

Introduction/Aim. Roughly six percent of all malignancies diagnosed in children are malignant bone tumors. They have a dramatic effect on psychological status of children and their families. The aim of the study was to analyze the clinico-pathological features of bone tumors in Iraqi children and to assess response to treatment, outcome, and survival. Patients and methods. Over an eleven-year period, a retrospective study was done for children with bone tumors conducted on patients data that included a battery of pre-treatment investigations including a complete blood count, serum electrolyte, hepatic, and renal profile, bone marrow aspirate and biopsy, fine-needle aspiration, and imaging studies. Results. Data of 41 children with bone tumor were collected. The most common site of involvement was lower limbs, found in 21 (51.2%) cases. At the time of diagnosis, 29 patients presented with localized disease (70.7%), while 12 (29.3%) patients presented with metastasis. From 41 patients included in the study, histopathology of 29 (70.7%) patients was Ewing's sarcoma, whereas 12 (29.3%) patients were diagnosed with osteogenic sarcoma. The most common toxic effect of chemotherapy was febrile neutropenia which was recorded in 22 (59.5%) patients, followed by hemorrhagic cystitis in 3 (8.1%) patients; both febrile neutropenia and hemorrhagic cystitis were recorded in 5 (13.5%) patients, convulsion was found in 1 (2.7%) patient, and no complication were reported in 5 (13.5%) patients. Relapse was found in 8 (21.6%) patients. Conclusion. High rate of patients were lost to follow-up. Two-year event-free survival (EFS) was 53%, which is lower than that reported in other studies due to late diagnosis, late referral with the presentation in the locally advanced stage of disease.