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Roganovic J, Virgone C, Ben-Ami T, Reguerre Y, Ferrari A, Orbach D, Godzinski J, Bisogno G, Farinha NJ, Krawczyk M, Schneider DT, Brecht IB, Bien E. Paediatric very rare tumours registration and management in European countries with low health expenditure average rates. Clin Transl Oncol 2024:10.1007/s12094-024-03674-3. [PMID: 39225960 DOI: 10.1007/s12094-024-03674-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 08/13/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE Within the Paediatric Rare Tumours Network-European Registry (PARTNER) project, we aimed to evaluate the situation on the registration and management of paediatric patients affected by very rare tumours (VRT) in the European low health expenditure average rates (LHEAR) countries. METHODS A survey regarding infrastructure, organisation, and clinical decision-making information on VRT was designed. This survey was distributed to the representatives of LHEAR countries involved in the activities of the PARTNER Work Package 7. RESULTS Eighteen answers from 17 countries were collected regarding the national organisation, methods of registration of VRT cases, the availability of medical experts in VRT, the access to updated diagnostic and therapeutic procedures (such as proton therapy, immunotherapy and, targeted therapies), and research on paediatric VRT. A high variability in the registration and management of patients with VRT has been observed with additional wide inequalities in pathology review, uniformity of clinical decisions, availability of selected procedures, and diagnostic and research tools. CONCLUSION In the majority of LHEAR countries, no clinical or research structures have been implemented for children and adolescents with VRT. Therefore, VRT still have an orphan status in these countries. These significant differences on the technology access and use between European regions need to be addressed.
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Affiliation(s)
- Jelena Roganovic
- Department of Hematology and Oncology, Children's Hospital Zagreb, Zagreb, Croatia
| | - Calogero Virgone
- Pediatric Surgery Division, University of Padua, University Hospital of Padua, Via Giustiniani 3, 35128, Padua, Italy.
- Department of Women's and Children's Health, University of Padua, Padua, Italy.
| | - Tal Ben-Ami
- Pediatric Hematology Unit, Kaplan Medical Center, Rehovot, Israel
| | - Yves Reguerre
- Pediatric Oncology and Hematology Unit, CHU Saint Denis de La Réunion, Bellepierre, France
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Daniel Orbach
- SIREDO Oncology Centre (Care, Innovation and Research for Children, Adolescents and Young Adults With Cancer), Institut Curie, PSL University, Paris, France
| | - Jan Godzinski
- Department of Pediatric Surgery, Marciniak Hospital, Wroclaw, Poland
- Department of Pediatric Traumatology and Emergency Medicine, Medical University Wroclaw, Wroclaw, Poland
| | - Gianni Bisogno
- Department of Women's and Children's Health, University of Padua, Padua, Italy
- Pediatric Hematology Oncology Division, University Hospital of Padua, Padua, Italy
| | | | - Malgorzata Krawczyk
- Hematology and Oncology, Department of Pediatrics, Medical University of Gdansk, Gdansk, Poland
| | - Dominik T Schneider
- Clinic of Pediatrics, Dortmund Municipal Hospital, University Witten/Herdecke, Witten, Germany
| | - Ines B Brecht
- Pediatric Hematology and Oncology, Children's Hospital, Eberhard-Karls-Universität, Tübingen, Germany
| | - Ewa Bien
- Hematology and Oncology, Department of Pediatrics, Medical University of Gdansk, Gdansk, Poland
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Stetson A, Saluja S, Cameron DB, Mansfield SA, Polites SF, Honeyman JN, Dahl JP, Austin MT, Aldrink JH, Christison-Lagay ER. Surgical management of rare tumors (Part 1). Pediatr Blood Cancer 2024:e31287. [PMID: 39185712 DOI: 10.1002/pbc.31287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 08/07/2024] [Accepted: 08/10/2024] [Indexed: 08/27/2024]
Abstract
With an annual cumulative occurrence of approximately 15,000 in North America, all childhood cancers are rare. Very rare cancers as defined by both the European Cooperative Study Group for Rare Pediatric Cancers and the Children's Oncology Group fall into two principal categories: those so uncommon (fewer than 2 cases/million) that their study is challenging even through cooperative group efforts (e.g., pleuropulmonary blastoma and desmoplastic small round cell tumor) and those that are far more common in adults and therefore rarely studied in children (e.g., thyroid, melanoma, and gastrointestinal stromal tumor). Treatment strategies for these latter tumors are typically based on adult guidelines, although the pediatric variants of these tumors may harbor different genetic signatures and demonstrate different behavior. If melanoma and differentiated thyroid cancer are excluded, other rare cancer types account for only 2% of the cancers in children aged 0 to 14. This article highlights several of the most common rare tumor types.
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Affiliation(s)
- Alyssa Stetson
- Department of Surgery, Division of Pediatric Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Saurabh Saluja
- Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Danielle B Cameron
- Department of Surgery, Division of Pediatric Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sara A Mansfield
- Division of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - Joshua N Honeyman
- Division of Pediatric Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - John P Dahl
- Division of Otolaryngology, Division of Pediatric Otolaryngology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Mary T Austin
- Department of Pediatric Surgery, University of Texas Health Science Center at Houston and Department of Surgical Oncology and Pediatrics, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Jennifer H Aldrink
- Division of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Emily R Christison-Lagay
- Division of Pediatric Surgery, Yale School of Medicine, Yale-New Haven Hospital, New Haven, Connecticut, USA
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3
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Gow KW, Lautz TB, Malek MM, Cost NG, Newman EA, Dasgupta R, Christison-Lagay ER, Tiao GM, Davidoff AM. Children's Oncology Group's 2023 blueprint for research: Surgery. Pediatr Blood Cancer 2024; 71:e30766. [PMID: 37950538 PMCID: PMC10872730 DOI: 10.1002/pbc.30766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
Surgery plays a crucial role in the treatment of children with solid malignancies. A well-conducted operation is often essential for cure. Collaboration with the primary care team is important for determining if and when surgery should be performed, and if performed, an operation must be done in accordance with well-established standards. The long-term consequences of surgery also need to be considered. Indications and objectives for a procedure vary. Providing education and developing and analyzing new research protocols that include aims relevant to surgery are key objectives of the Surgery Discipline of the Children's Oncology Group. The critical evaluation of emerging technologies to ensure safe, effective procedures is another key objective. Through research, education, and advancing technologies, the role of the pediatric surgeon in the multidisciplinary care of children with solid malignancies will continue to evolve.
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Affiliation(s)
- Kenneth W. Gow
- Division of General & Thoracic Surgery, Seattle Children’s Hospital, Seattle, Washington, USA
| | - Timothy B. Lautz
- Department of Pediatric Surgery, Lurie Children’s Hospital of Chicago, Northwestern University School of Medicine, Chicago, Illinois, USA
| | - Marcus M. Malek
- Division of Pediatric General and Thoracic Surgery, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nicholas G. Cost
- Department of Surgery, Division of Urology and the Surgical Oncology Program, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Erika A. Newman
- Department of Surgery, Mott Children’s Hospital, University of Michigan, Ann Arbor, Michigan, USA
| | - Roshni Dasgupta
- Division of Pediatric General and Thoracic Surgery, Cincinnati Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Emily R. Christison-Lagay
- Division of Pediatric Surgery, Yale School of Medicine, Yale-New Haven Children’s Hospital, New Haven, Connecticut, USA
| | - Gregory M. Tiao
- Division of Pediatric General and Thoracic Surgery, Cincinnati Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Andrew M. Davidoff
- Department of Surgery, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
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Mallebranche C, Reguerre Y, Fresneau B, Andre N, Berger C, Briandet C, Castex MP, Defachelles AS, Faure-Conter C, Lejeune J, Klein S, Leverger G, Marie-Cardine A, Oudot C, Freycon C, Proust S, Roumy M, Thebaud E, Verite C, Lacour B, Orbach D. The French FRACTURE database: A way to improve knowledge on management of children with very rare tumors. Pediatr Blood Cancer 2022; 69:e30003. [PMID: 36156381 DOI: 10.1002/pbc.30003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/28/2022] [Accepted: 08/29/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Very rare pediatric tumors (VRTs), defined by an annual incidence ≤2 per million inhabitants, represent a heterogeneous group of cancers. Due to their extremely low incidence, knowledge on these tumors is scant. Since 2012, the French Very Rare Tumors Committee (FRACTURE) database has recorded clinical data about VRTs in France. This study aims: (a) to describe the tumors registered in the FRACTURE database; and (b) to compare these data with those registered in the French National Registry of Childhood Cancer (RNCE). METHODS Data recorded in the FRACTURE database between January 1, 2012 and December 31, 2018 were analyzed. In addition, these data were compared with those of the RNCE database between 2012 and 2015 to evaluate the completeness of the documentation and understand any discrepancies. RESULTS A total of 477 patients with VRTs were registered in the FRACTURE database, representing 97 histological types. Of the 14 most common tumors registered in the RNCE (772 patients), only 19% were also registered in the FRACTURE database. Total 39% of children and adolescent VRTs registered in the RNCE and/or FRACTURE database (323 of a total of 828 patients) were not treated in or linked to a specialized pediatric oncology unit. CONCLUSION VRTs represent many different heterogenous entities, which nevertheless account for 10% of all pediatric cancers diagnosed each year. Sustainability in the collection of these rare tumor cases is therefore important, and a regular systematic collaboration between the FRACTURE database and the RNCE register helps to provide a more exhaustive picture of these VRTs and allow research completeness for some peculiar groups of patients.
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Affiliation(s)
| | - Yves Reguerre
- Pediatric Oncology and Hematology Unit, CHU Saint Denis de la Réunion, Bellepierre, France
| | - Brice Fresneau
- Department of Child and Adolescent Cancer, Gustave Roussy Institute, Villejuif, France
| | - Nicolas Andre
- Pediatric Oncology, La Timone Hospital, Marseille, France
| | - Claire Berger
- Lyon University, Jean Monnet University, INSERM, U1059, Sainbiose, University Hospital, Pediatric Hematology-Oncology Department, Saint-Etienne, France
| | | | | | | | - Cécile Faure-Conter
- Pediatric Oncology, Institute of Pediatric Hematology and Oncology (IHOPe), Lyon, France
| | - Julien Lejeune
- Pediatric Oncology and Hematology, CHRU Tours, Tours, France
| | - Sébastien Klein
- Pediatric Oncology and Hematology, CHU Jean-Minjoz, Besançon, France
| | - Guy Leverger
- Hemato-Immuno-Oncology, Trousseau Hospital, APHP, Paris, France
| | | | | | - Claire Freycon
- Pediatric Onco-Hematology, CHU Grenoble - Hôpital Couple-Enfant, La Tronche, France
| | - Stéphanie Proust
- Pediatric Immuno-Hemato-Oncology Unit, CHU Angers, Angers, France
| | - Marianne Roumy
- Pediatric Clinical Research Platform, CHU Angers, Angers, France
| | - Estelle Thebaud
- Pediatric Immuno-Hemato-Oncology Unit, CHU Nantes, Nantes, France
| | - Cécile Verite
- Pediatric Hematology and Oncology, CHU Bordeaux, Bordeaux, France
| | - Brigitte Lacour
- French National Registry of Childhood Solid Tumors, CHU Nancy, Nancy, France.,Inserm UMR 1153, Centre of Research in Epidemiology and StatisticS (CRESS), Paris University, Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris, France
| | - Daniel Orbach
- SIREDO Oncology Centre (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
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de Campos Vieira Abib S, Chui CH, Cox S, Abdelhafeez AH, Fernandez-Pineda I, Elgendy A, Karpelowsky J, Lobos P, Wijnen M, Fuchs J, Hayes A, Gerstle JT. International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines. Ecancermedicalscience 2022; 16:1356. [PMID: 35510137 PMCID: PMC9023308 DOI: 10.3332/ecancer.2022.1356] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Indexed: 12/14/2022] Open
Abstract
Most children with tumors will require one or more surgical interventions as part of the care and treatment, including making a diagnosis, obtaining adequate venous access, performing a surgical resection for solid tumors (with staging and reconstruction), performing procedures for cancer prevention and its late effects, and managing complications of treatment; all with the goal of improving survival and quality of life. It is important for surgeons to adhere to sound pediatric surgical oncology principles, as they are closely associated with improved local control and survival. Unfortunately, there is a significant disparity in survival rates in low and middle income countries, when compared to those from high income countries. The International Society of Paediatric Surgical Oncology (IPSO) is the leading organization that deals with pediatric surgical oncology worldwide. This organization allows experts in the field from around the globe to gather and address the surgical needs of children with cancer. IPSO has been invited to contribute surgical guidance as part of the World Health Organization Initiative for Childhood Cancer. One of our goals is to provide surgical guidance for different scenarios, including those experienced in High- (HICs) and Low- and Middle-Income Countries (LMICs). With this in mind, the following guidelines have been developed by authors from both HICs and LMICs. These have been further validated by experts with the aim of providing evidence-based information for surgeons who care for children with cancer. We hope that this initiative will benefit children worldwide in the best way possible. Simone Abib, IPSO President Justin T Gerstle, IPSO Education Committee Chair Chan Hon Chui, IPSO Secretary.
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Affiliation(s)
- Simone de Campos Vieira Abib
- Pediatric Oncology Institute, GRAACC, Federal University of São Paulo, Rua Pedro de Toledo, 572 - Vila Clementino, São Paulo, SP 04021-001, Brazil
| | - Chan Hon Chui
- Surgery Centre for Children, Mount Elizabeth Medical Centre, 3 Mount Elizabeth, 228510, Singapore
| | - Sharon Cox
- Division of Paediatric Surgery, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
| | - Abdelhafeez H Abdelhafeez
- Department of Surgery, St Jude Research Hospital 262 Danny Thomas Place. MS133, Memphis, TN 38105, USA
| | - Israel Fernandez-Pineda
- Department of Pediatric Surgery, Virgen del Rocio Children’s Hospital, Av Manuel Siurot S/NN, Sevilla 41013, Spain
| | - Ahmed Elgendy
- Surgical Oncology Unit, Faculty of Medicine, Tanta University, Elgiesh Street, 31111, Tanta, Gharbeya, Egypt
| | - Jonathan Karpelowsky
- Department of Paediatric Surgery, Children’s Hospital at Westmead, Westmead NSW 2145, Australia
| | - Pablo Lobos
- Pediatric Surgery Division, Hospital Italiano de Buenos Aires, Andrés Lamas 812, Buenos Aires 1406, Argentina
| | - Marc Wijnen
- Department of Surgery, Princess Maxima Center for Pediatric Oncology, Huispostnummer KE 01.129.2, Postbus 85090, Utretcht 3508AB, The Netherlands
| | - Jörg Fuchs
- Department of Pediatric Surgery and Pediatric Urology, University of Tuebingen, Hoppe-Seyler-Str. 3, Tübingen 72076, Germany
| | - Andrea Hayes
- Department of Surgery, Howard University Hospital, 1851 9th Street NW, 4th Floor, Washington, DC 20059, USA
| | - Justin T Gerstle
- Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
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6
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Hippert F, Desing L, Diez S, Witowski A, Bernbeck B, Abele M, Seitz C, Erdmann F, Brecht I, Schneider DT. Rare Tumors in Children and Adolescents - the STEP Working Group's Evolution to a Prospective Registry. KLINISCHE PADIATRIE 2021; 234:146-153. [PMID: 34798669 DOI: 10.1055/a-1675-3145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background Very rare tumors (VRT) in children and adolescents have such a low incidence that until recently, they have not been integrated into the clinical and scientific network of pediatric oncology. Data is very limited and consistent treatment strategies are missing. Thus, VRTs are classic orphan diseases. To counteract this problem, the Arbeitsgemeinschaft für Seltene Tumorerkrankungen in der Pädiatrie (STEP) was founded. Here we report on patient recruitment during the first 10 years. Patients Patients aged up to 18 years and not included in any other clinical trial or GPOH registry were included in this analysis. Methods Data was collected from 2008 to 2018 by means of a standardized form. The recorded diagnoses were descriptively analyzed focusing on histology, localization, and year of report. Results A total of 623 patients with VRTs were registered. During 2008-2014, the annual number of registrations was around 40 and is around 90 since 2015. Most frequent diagnoses included tumors of the skin (n=150), tumors of the gastrointestinal tract (n=102), tumors of the gonads (n=77), the ENT region (n=68), and miscellaneous tumors (n=107). Discussion With the establishment of central structures for clinical consultation and documentation of VRTs, the number of registrations increased. Comprehensively, VRTs are as common as other classic pediatric oncology tumors, but extremely heterogeneous in terms of localization, histology, and prognosis. By a centralized and complete registration and analysis of VRTs, also in collaboration with international partners, it is possible to develop treatment strategies and thus greatly increase treatment quality.
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Affiliation(s)
- Felicitas Hippert
- Clinic of Pediatrics, Municipal Hospital Dortmund, Dortmund, Germany
| | - Lena Desing
- Clinic of Pediatrics, Hospital Weiden, Weiden, Germany
| | - Sonja Diez
- Pediatric Surgery, Erlangen University Hospital, Erlangen, Germany
| | - Andrea Witowski
- Clinic of Pediatrics, Municipal Hospital Dortmund, Dortmund, Germany
| | - Benedikt Bernbeck
- Clinic of Pediatrics, Municipal Hospital Dortmund, Dortmund, Germany
| | - Michael Abele
- Pediatric Hematology/Oncology, University Hospital Tubingen Department of Pediatrics, Tubingen, Germany
| | - Christian Seitz
- Pediatric Hematology/Oncology, University Hospital Tubingen Department of Pediatrics, Tubingen, Germany
| | - Friederike Erdmann
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ines Brecht
- Pediatric Hematology/Oncology, University Hospital Tubingen Department of Pediatrics, Tubingen, Germany
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