<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2020-0059_s_005_w2aab3b7b4b1b6b1aab1c16b1Aa"><h3>Background</h3><p>Survival of children with cancer in Eastern and Central Europe is 10–20% lower than in high income European countries. We evaluated outcome of children and adolescents with rhabdomyosarcoma (RMS) in Slovenia, Croatia, Slovakia and in Romania.</p></sec><sec id="j_raon-2020-0059_s_006_w2aab3b7b4b1b6b1aab1c16b2Aa"><h3>Patients and methods</h3><p>We retrospectively analysed event-free survival (EFS) and overall survival (OS) for all patients treated in Slovenia and Croatia. Slovakia included patients from two centers, representing half of expected cases. Romania included patients from single institution, representing only 10% of expected patients. Joint database for analysis was established.</p></sec><sec id="j_raon-2020-0059_s_007_w2aab3b7b4b1b6b1aab1c16b3Aa"><h3>Results</h3><p>One hundred seventy-eight children and adolescent with RMS diagnosed from January 2000 to December 2015 were included. Mean patient age at diagnosis was 7.7 years, one third was older than 10 years. Twenty-five percent had alveolar histology and 72% unfavorable location. Higher than expected proportion of patients had nodal involvement (24%) or metastatic disease (27%). All patients received systemic chemotherapy, 57% had radiotherapy and 63% surgery as local control. Kaplan- Meier estimates for 5-year EFS and OS were 50.7% and 59.6%, respectively. Five-year OS for patients with localised disease was 72% compared to 24% for metastatic disease.</p></sec><sec id="j_raon-2020-0059_s_008_w2aab3b7b4b1b6b1aab1c16b4Aa"><h3>Conclusions</h3><p>Children with RMS treated in Eastern and Central Europe have inferior outcome compared to their counterparts treated in high income European countries. Active participation of low health expenditures average rates (LHEAR) countries in international clinical trials may improve outcome of paediatric oncology patients.</p></sec></abstract>

BackgroundSurvival of children with cancer in Eastern and Central Europe is 10–20% lower than in high income European countries. We evaluated outcome of children and adolescents with rhabdomyosarcoma (RMS) in Slovenia, Croatia, Slovakia and in Romania.Patients and methodsWe retrospectively analysed event-free survival (EFS) and overall survival (OS) for all patients treated in Slovenia and Croatia. Slovakia included patients from two centers, representing half of expected cases. Romania included patients from single institution, representing only 10% of expected patients. Joint database for analysis was established.ResultsOne hundred seventy-eight children and adolescent with RMS diagnosed from January 2000 to December 2015 were included. Mean patient age at diagnosis was 7.7 years, one third was older than 10 years. Twenty-five percent had alveolar histology and 72% unfavorable location. Higher than expected proportion of patients had nodal involvement (24%) or metastatic disease (27%). All patients received systemic chemotherapy, 57% had radiotherapy and 63% surgery as local control. Kaplan- Meier estimates for 5-year EFS and OS were 50.7% and 59.6%, respectively. Five-year OS for patients with localised disease was 72% compared to 24% for metastatic disease.ConclusionsChildren with RMS treated in Eastern and Central Europe have inferior outcome compared to their counterparts treated in high income European countries. Active participation of low health expenditures average rates (LHEAR) countries in international clinical trials may improve outcome of paediatric oncology patients.

Treatment of rhabdomyosarcoma in children and adolescent from four low health expenditures average rates countries

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundSurvival of children with cancer in Eastern and Central Europe is 10–20% lower than in high income European countries. We evaluated outcome of...

Country	Slovenia	Croatia	Slovakia	Romania
Number (pt)	25	72	40	41
Age < 1 year	1	2	3	3
Age > 10 years	8	21	12	17
Favourable histology	19	41	31	30
Unfavourable histology	5	21	8	11
Primary surgery
Biopsy	20	50	28	26
R0	2	19	4	8
R1	1	3	8	3
R2	2	NA	NA	4
Site
Orbit	2	3	7	1
Paratesticular	1	6	8	6
Vagina/uterus	1	1	1	NA
Head/neck	NA	3	2	6
Parameningeal	12	22	3	13
Extremity	NA	7	9	5
Abdomen	NA	19	6	5
Thorax	7	5	1	2
Bladder/prostate	2	6	3	3
Size (> 5 cm)	13	44	32	24
Nodes +	6	31	12	18
Metastases +	6	24	13	5
RT	21 (84%)	39 (54%)	21 (52%)	21 (51%)
RTsalvage	2	13	5	7
Secondary surgery	7	29	18	12
R0	1	11	9	3
R1	5	6	4	8
R2	1	12	1	1
Primary+secondary surgery	12 (48%)	51 (70%)	26 (65%)	27 (65%)
Alive	16 (64%)	44 (61%)	23 (57%)	23 (56%)

Treatment of rhabdomyosarcoma in children and adolescent from four low health expenditures average rates countries

Article Category: Research Article

Published Online: Oct 21, 2020

Page range: 455 - 460

Received: Jun 18, 2020

Accepted: Sep 08, 2020

DOI: https://doi.org/10.2478/raon-2020-0059

© 2020 Maja Cesen Mazic, Aleksandra Bonevski, Martina Mikeskova, Emilia Mihut, Gianni Bisogno, Janez Jazbec, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

Figure 3

Patient and disease characteristics