Effect of symptom interval and demographic characteristics on initial stage of malignant tumors in children
R. Grujicic, , O. Djurmez, M. Trkulja, J. Lazić, M. Bjelić
School of Medicine, University of Belgrade, Serbia

Aim: The aim of our retrospective study was to determine the influence of demographic and clinical characteristics of patients, initial stage of disease and tumor size on symptom period in children with malignant tumors.

Introduction: One of the main goals in pediatric oncology is timely diagnosis, cause it allows prompt and more effective treatment and significantly decreases the number of complications. The majority of children with malignant tumors have specific or non-specific symptoms certain time period before the diagnosis which can point towards malignant disease.

Methods: Our study included 296 children with malignant tumors, diagnosed and

treated between 2005 and 2016 in University Children's Hospital in Belgrade. Collected data included sociodemographic parameters, variety of symptoms and its duration, initial stage of disease and size of the tumor.

Results: The most frequent tumors were as follows: neuroblastoma, Hodgkin and non-Hodgkin lymphoma and kidney tumors. Non-Hodgkin lymphoma was diagnosed more frequently in boys, while Ewing sarcoma and primitive neuroectodermal tumors were seen mostly in girls. The majority was admitted at IV stage (30.1%) in opposite to 13.5% of patients in I stage. The average symptom interval was 87.7 days (median 46; SD=164), from 5 to 2190 days. We have proven that following factors have significant effect on the extent of symptom interval: age (p<0.001), type of tumor (p<0.05), its localization (p<0.001), specific symptoms (p<0.05), and refferal from primary health care unit in comparison to secondary one (p<0.05).

Conclusion: The results of our study give a new insight in symptom interval of children with malignant tumors in our country. More detailed comprehension of patients’ characteristics, their diseases, healthcare system and their effect on symptom interval could significantly contribute to early diagnosis, as well as decreased number of complications at admission and during treatment.1–6

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