Abstract 4248: Small round blue cell tumour of childhood. A case of health disparity in Nigeria in the survival of patients

Abstract

Abstract Introduction Nigeria is Africa's most populous country and the 9th most populous country in the world. The country is the 6th largest producer of petroleum in the world. Health care and general living conditions in Nigeria are poor, especially for children and women. At least 70 to 75 percent of health expenditure comes from out of pocket expenses. Childhood cancers as a growing public health challenge and is increasingly being recognized worldwide, including the developing nations. Tremendous progress has been made in the treatment and cure of childhood cancers mostly in the developed world, most cases die of childhood cancers in our society. We look at fifty two cases of small round blue cell tumour of childhood (SRBCT) a diverse group of childhood cancers that have considerable overlap in epidemiology, morphology and immunophenotype over a three year period. Methods We reviewed the histology report and paraffin blocks of patients diagnosed as SRBCT of childhood in the department of pathology, from 2014-2017. We identified fifty two patients diagnosed as SRBCT during the study period. The information extracted includes age, sex, cancer type, treatment modality and outcome of all patients. We subjected the blocks to nine immunohistochemical stains to rule out differentials using Genemed biotechnology protocol. The stains include Cytokeratin, EMA, S-100, CD99, Desmin, CD10, CD20, BCL2 and Synaptophysin.. Results The age range in this study was 2-15 years with a mean of 7.2 years. The most common site for SRBCT was the head and neck region accounting for more than 46%. This is followed by the abdomen accounting for 19%. The commonest SRBCT after immunohistochemical stains was Burkitt's lymphoma 16(30.7%), retinoblastoma 8(15.4%), alveolar rhabdomyosarcoma 7(13.5%), Follicular lymphoma 5(9.6%), ES/PNET 5(9.6%), nephroblastoma 4(7.7%), neuroblastoma 4(7.7%) and synovial sarcoma 3(5.8%). All patients 52(100%) undergo chemotheraphy, 36(69%) undergo both surgery and chemotheraphy while 8(15.4%) sign against medical advice. All patients pay through out of pocket expences with no access to insurance. Thirty three patients (63%) died during chemotheraphy. Most patients are lost to follow up due to financial burden and unavailability of standard oncology services. Conclusion While tremendous progress has been made in the treatment of childhood cancers in the developed world, it still remains an important health problem in our societies largely because of multifactorial reasons creating a huge health disparity and contributing to under five mortality in our environment. Reducing poverty and creating better health facilities through knowledge sharing and collaboration with reduce this disparity. Citation Format: Kasimu U. Adoke, Faruk Mohammed. Small round blue cell tumour of childhood. A case of health disparity in Nigeria in the survival of patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4248.