Pediatric genitourinary tumors: Distribution, demographics, and outcomes. Issue 2 (31st March 2022)

• Record Type: Journal Article
• Authors: Nazemi, Azadeh; Daneshmand, Siamak; Chang, Andy
• Is Part Of: Pediatric investigation. Volume 6:Issue 2(2022)
• Page Start: 85
• Page End: 92
• Publication Date: 2022-03-31
• Subjects: Bladder cancer -- Epidemiology -- Genitourinary cancers -- Kidney cancer -- Pediatrics -- Prostate cancer -- Testis cancer -- Vaginal cancer; Pediatrics -- Periodicals; Pediatrics -- Research -- Periodicals; 618.920005
• DOI: 10.1002/ped4.12318
• Languages: English
• ISSNs: 2574-2272

Abstract

ABSTRACT: Importance: The diversity of pediatric genitourinary malignancies requires a timely resource detailing tumor characteristics and survival. Objective: To determine the incidence, demographics, and outcomes of all pediatric genitourinary tumors within the United States. Methods: A population‐based search for patients diagnosed with genitourinary cancers under age 15 was performed using the National Cancer Institute's Surveillance, Epidemiology, and End Results 18 registry. Information on primary tumor location, histologic type, patient age, sex, year of diagnosis, race, treatment, cause of death, and survival months was extracted. Descriptive epidemiological and survival statistics were calculated for all variables. Results: A total of 4576 cases from 1973 through 2015 were identified. The most common primary tumor sites were the kidney (80.3%), testis (12.3%), bladder (2.8%), and vagina (1.5%). Nephroblastoma (87.9%) and sarcoma (3.4%) were the most common renal malignancies. Rhabdomyosarcoma was common in the vagina, bladder, and testis at rates of 66.2%, 61.2%, and 24.6%, respectively. Germ cell tumors (71.0%) were the most common primary tumor of the testis. Ten‐year overall survival (OS) for renal nephroblastoma and sarcoma was 88% and 82%, respectively. Ten‐year OS for RMS of the testis was 91%, the bladder was 79%, the vagina was 79%, and the prostate was 56%. Germ cell tumor 10‐year OS were 96% in the testis and 100% in the vagina. Interpretation: A better understanding of the overall distribution and outcomes associated with pediatric genitourinary cancers allows physicians to best understand the patient's disease in the context of current frequency in a genitourinary setting and reported outcomes. Abstract : Childhood urologic cancers are rare entities. A comprehensive cancer database (SEER) search identified 4, 756 patients under the age of 15 with genitourinary cancer from 1973 to 2015. The most common primary tumor site was the kidney (80.3%), followed by the testis (12.3%), bladder (2.8%), vagina (1.5%), prostate (1.3%), cervix and uterus (0.8%), scrotum (0.5%), and other unspecified genitourinary organs. The most common tumors in both males and females were renal nephroblastomas, while the remaining common tumors differed based on gender. Over time, there was a significant improvement in overall survival for renal nephroblastomas, renal nervous system tumors, testicular lymphomas, testicular germ cell tumors, and prostate rhabdomyosarcomas. There was no significant difference in overall survival across generations for renal cell carcinoma, renal sarcomas, testicular rhabdomyosarcoma, or any bladder or vaginal malignancies. A 5‐year‐old girl with a headache was found to have a space‐occupying lesion in the right cerebral hemisphere. The patient was identified by stereotactic biopsy as tumor‐like primary angiitis of the central nervous system(PACNS). After immunotherapy, her symptoms improved significantly. This alerts pediatricians to the possibility of PACNS if intracranial space occupying lesions are found.