Clinicopathological characteristics and treatment patterns in children with Rhabdomyosarcoma at Tikur Anbessa Specialized Hospital, Ethiopia

Abstract

Background: Rhabdomyosarcoma (RMS) is the most common type of soft tissue sarcoma in children and adolescents, making up almost half of all cases. The clinical presentation of rhabdomyosarcoma varies on the site of involvement and the histological subtypes vary based on the age and site of occurrence. This study aimed to summarize pediatric RMS patients' clinical profiles and histological subtypes.

Methods: This retrospective study was conducted at Tikur Anbessa Hospital in children diagnosed with RMS between March 2017 to March 2022. The collected data comprised the socio-demographic profile of patients, the clinical characteristics, the histological subtypes ,and treatment patterns of RMS. The collected data were analyzed using a statistical package for social sciences (SPSS) version 25. A chi-square test was performed to assess the association between variables.

Results: Fifty histopathologically confirmed RMS patients met the inclusion criteria. Most patients (66%) were under five years old, with a median age of three years (range: 1 month to 14 years). Time from symptom onset to pediatric oncology presentation ranged from 1 week to 2 years, with a median of five months. Swelling was the most common symptom (90%, n=45), and the head and neck were the most frequently affected sites (56%). One-fifth (20%) had distant metastasis at diagnosis. Embryonal RMS was the most common histology subtype (53.7%), followed by alveolar RMS (41.5%). Nearly all patients (96%) received systemic chemotherapy, while 52.1% underwent combination therapy, including surgery and radiotherapy.  

Conclusion: Most pediatric patients diagnosed with rhabdomyosarcoma were younger than five years old and experienced delayed presentation  of  more  than  three months  from  the  onset  of symptoms. Emphasis has to be given to improving early diagnosis of pediatric rhabdomyosarcoma and the practice of local therapy measures has to be strengthened.