Challenges in treating pediatric neuroblastoma at The Children’s Hospital and Institute of Child Health, Lahore

Abstract

Objective: To demonstrate challenges in treating pediatric neuroblastoma at The Children’s Hospital and Institute of Child Health, Lahore.

Study design: Descriptive observational study

Place and duration: The study was conducted in Pediatric Hematology Oncology department, The Children’s Hospital and the Institute of Child Health, Lahore in twelve months from March 2020 to  February 2021.

Methodology: Study was conducted on total of 60 patients of diagnosed neuroblastoma. Main variables of study were age, parents education, socioeconomic status, traveling distance, LTS, and INSS stage. SPSS version 23.1 was used for data analysis. Test of significance was applied taking p value ≤0.05 as significant value.

Results: Regarding histopathology, fifty eight 96% patients had neuroblastoma while 4% patients had ganglioneuroblastoma. Life threatening symptoms were present in 85% patients. Most common primary sites were suprarenal 45%, retroperitoneum 25%, pre/paravertebral 11%, posterior mediastinal 11%, others 6%. Metastasis were present in 40% patients at diagnosis and most common metastatic sites were bone marrow 21%, bone 8% and both 10%.

Conclusion: Advanced disease presentation is common, high-risk neuroblastoma is considered challenging and has one of the least favorable outcomes amongest cancers. Late diagnosis due to cultural and socioeconomic barriers and lack of care at primary care level and poor referral to oncology units owing to deficient health care system are the major contributory challenges for management and poor outcomes.

Keywords: Neuroblastoma, Challenges, Management, Children