Clinical analysis of malignant solid tumors in the digestive tract in children and adolescents

Abstract

Objective To explore the clinical features, treatment and prognosis of malignant solid tumors in the digestive tract in children and adolescents. Methods Sixty-five children and adolescents with malignant solid tumors in the digestive tract from January 1997 to June 2017 were selected, who were treated at the Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital.The tumor site, gender, age, clinical presentations, treatment, follow-up time and their life status by deadline follow-up in 65 children and adolescents were collected respectively, and the clinical features, treatment methods and prognosis were retrospectively analyzed.The follow-up deadline was on December 31, 2017. Results The most frequent sites of tumors were liver tumor(36 cases, 55.38%), followed by rectum tumor(11/65 cases, 16.92%), colon tumor(6/65 cases, 9.23%), pancreas tumor(5/65 cases, 7.69%), gastric(3/65 cases, 4.62%), esophagus(1/65 cases, 1.54%), gallbladder tumor(1/65 cases, 1.54%), ileum tumor(1/65 cases, 1.54%), and appendix tumor(1/65 cases, 1.54%). The prevalence rate in males and females was 1.321.00.The age of embryo tumor incidence was smaller, and the age of epithelium cancer incidence was older.The main symptoms included abdominal distension and pain (66.15%, 43/65 cases). Twenty-seven patients (41.5%, 27/65 cases) was in stage Ⅳ.Radical and palliative surgery were the main treatment in 50 cases (76.92%). The 1-year, 3-year, 5-year overall survival rates were 60.7%, 31.0%, 18.8%, respectively.The overall survival rate of colon and rectal cancer was higher than that of hepatocellular cancer, and the differences were all statistically significant(χ2=6.268, P=0.012; χ2=11.772, P=0.001). The overall survival rate of patients who received surgery combined with chemoradiotherapy was the longest and those undergoing chemotherapy only was the shortest, but the differences had no statistical significance among 4 groups of sheer surgery, chemotherapy alone, surgery combined with chemotherapy and surgery combined with chemoradiotherapy(all P>0.05). Conclusion The malignant solid tumors in the digestive tract in children and adolescents have a poor prognosis.The unspecific presentation makes the diagnosis difficult.It is very important to diagnose early and treat as soon as possible by the combination of surgery, chemotherapy and radiotherapy to improve the overall survival rate. Key words: Child; Adolescent; Digestive tract; Malignant solid tumor; Clinical analysis