KẾT QUẢ PHẪU THUẬT KẾT HỢP HÓA TRỊ SARCÔM CƠ VÂN Ở TRẺ EM TẠI BỆNH VIỆN NHI ĐỒNG 2 TỪ NĂM 2019 – 2024

Abstract

Introduction: Rhabdomyosarcoma is a mesenchymal neoplasm with morphology and genetic features similar to skeletal muscle cells. It is the most common subtype of soft-tissue sarcoma. In Southern Vietnam, there are currently no studies evaluating rhabdomyosarcoma cases in detail or assessing survival according to stage and risk stratification. We conducted this study to assess treatment outcomes and survival based on stage and risk groups in children with rhabdomyosarcoma. From this, we aim to draw experience and define more effective treatment objectives for this disease.

Subjects and methods: We conducted a case series describing pediatric patients who were newly diagnosed and treated for rhabdomyosarcoma at Children’s Hospital 2 from January 1st, 2019 to June 30th, 2024.

Results: Among 30 patients, the median age at diagnosis was 3,5 years. Most patients were ≤ 5 years-old (63.3%). The male-to-female ratio was 1:1. A palpable mass was the most common symptom (80%). According to risk stratification, 3,3% (1/30) were in group B; 6,7% (2/30) in group C; 20% (6/30) in group E; 10% (3/30) in group F; 20% (6/30) in group G; 10% (3/30) in group H; and 30% (9/30) had metastatic disease. Regarding surgery, 7 patients (23.3%) underwent upfront tumor resection, 21 patients (70%) underwent delayed resection after chemotherapy, and 2 patients (6.7%) had unresectable tumors, being biopsied only. Surgical margin was tumor-free in 33,3% cases (10/30), while 66,7% (20/30) had residual disease, including 26,7% with microscopic residual tumor and 40% with macroscopic residual tumor. All patients (100%) received chemotherapy following CWS protocol. The rate of complete response at the end of treatment was 47,8%, representing a 39,1% increase compared to after – three – cycle period. Tumor resection was an independent factor associated with treatment response. The overall survival time was 527,3 ± 210 days; event-free survival time was 501,7 ± 208,3 days. The overall survival and event-free survival rates were 54,3% and 66,4%, respectively.