SURVIVAL AND TREATMENT OUTCOMES OF PEDIATRIC SOFT TISSUE AND BONE SARCOMAS IN TANZANIA

Abstract Background Pediatric sarcomas represent an important group of childhood tumors who require treatment at Muhimbili National Hospital (MNH), the largest pediatric oncology center in Tanzania. Treatment is often adapted from established childhood protocols validated in clinical trials from the United States and United Kingdom. There are no studies describing the outcomes of treatment in Tanzania to understand similarities and disparities with other countries. The objective of this study was to describe the treatment outcomes including the overall survival for children seen at MNH. Methods Data on treatment outcome was collected on all children seen at MNH pediatric oncology unit between 2011 and 2016 with a confirmed histological diagnosis of either bone or soft tissue sarcoma. Results A total of 135 cases were analyzed; 89 (66%) were Soft tissue sarcoma (STS) and 46 (34%) were bone sarcomas. In the STS group, 37 (41.6%) achieved a complete response, 12 (13.5%) achieved a partial response and 40 (44.9%) had no response. Factors found to be significantly associated with a higher complete response rate included early stage disease (stage I or II), embryonal histology, tumor in favorable sites and tumor size of <5cm for STS and <8cm for the bone sarcomas. There was a trend for better 2-year overall survival for STS in early stage disease (74.5%) compared to late stage disease (20.6%), p<0.001. A similar trend was noted for the bone sarcomas; 91.7% versus 25.3% for early stage and late stage disease respectively, p=0.001. Conclusions This report is the first study documenting the treatment outcome for pediatric sarcomas seen in Tanzania. Disease stage is strongly related to treatment outcome with later stages of the disease having an overall poor prognosis.