Spectrum of pediatric malignancy- A cancer hospital-based study

Objective: Childhood malignancy being a significant cause of mortality among children. The aim of the study is to find out the epidemiology of tumours in children in our region below <14 years age who presented to tertiary care Cancer hospital, Bhopal, M.P. for period of four years (2015- 2018). Methodology: All children with cancer, aged 1-14 years diagnosed by mean of histological and cytological examination during a period of 4 years were reviewed. Results: During the period of four years 275 patients were diagnosed as having paediatric malignancies. According to year wise distribution highest incidence of cases were found in 2016 (32.72%). The highest number of cases, 96(35%) were in 10-14 years of age group and mean age was 7.43 with SD 4.0. Male were affected more than females with ratio of 2.66:1. It was observed that haematological malignancies were more common 172(62.54%) than the non haematological malignancies 103(37.45%). Leukemia 150 (54.54%) is most common pediatric cancer amongst which Acute lymphoblastic leukemia is most common haematological malignancy. Overall, it was found that most common cancer group in the present study were leukemia (54%) followed by lymphoma (8.36%), Brain tumours (7.27%) and Sarcoma (7.27%). Conclusion: Although the exact incidence rate cannot be provided by this hospital-based study, the information is useful in showing distribution patterns of childhood malignancy in this region.


Introduction
Cancer in children can occur anywhere in the body, including the blood and lymph node, brain, spinal cord, kidney and other organs and tissue, Cancer begins when healthy cell change and grow out of control. In most type of cancer, these cells form a mass called a tumour. A tumour can be cancerous or benign. A cancerous tumour is malignant, meaning it can grow and spread to other part of the body. Tumors that occurs in children are as diverse as those in adult and present a number of challenges for pathologist [1].
Compared with cancers that occur in adult, childhood cancers are rare comprising only1% of all the cancers [2]. More than 10% of all death in children below 15-years of age are caused by malignant diseases in the developed countries. In the developing world, cancers are yet to be recognized as a major pediatric illness, however they are fast emerging as a distinct entity to be dealt upon [3]. Cancer is leading cause of death for children and adolescents around the world and approximately 300,000 children aged 0-15 years old are diagnosed with cancer each year [4]. Childhood malignancy being a significant cause of death among children. The aim of the study is to find out the spectrum of childhood (<14 years) cancers in patients who presented to Jawaharlal Nehru Cancer hospital, Bhopal, M.P. for period of four years (2015-2018).

Material and Method
Setting: This study was done in tertiary care Cancer hospital, Bhopal. M.P.

Duration:
In this study four years data was collected from January 2015 to December 2018.
Type study: A cancer hospital based retrospective study.
Inclusion criteria: All children with cancer, aged 1-14 years diagnosed by mean of histological and cytological examination during four years period in JNCH (Jawaharlal Nehru Cancer Hospital), Bhopal were included in the study.
Exclusion criteria: All suspected cases but not confirmed pathologically.

Pediatric Review: International Journal of Pediatric Research
Available online at: www.medresearch.in 28|P a g e Scoring system: The present study have followed ICCC (International childhood cancer classification) to classify the tumours In this retrospective study, four years of hospital records were used from January 2015 to December 2018. All children with cancer, aged 1-14 years diagnosed by mean of histological and cytological examination during that period in tertiary care hospital at Bhopal were included in the study. Patient from all over M.P. and Chhattisgarh and adjoining states attend this hospital for better cancer care and cure. Data was analyzed according to age, sex, and histopathological and cytological basis. All tumours were diagnosed on routine hematoxylin and eosin stained section; special stain and immunohistochemistry was applied wherever necessary.
Fine needle aspiration cytology was done in some cases only. For the diagnosis of leukemia, complete blood count with peripheral smear examination, bone marrow aspiration and biopsy, flow cytometry was done to confirm the diagnosis. For children, the ICCC (International childhood cancer classification) was used based on morphology of the tumours and is composed of 12 main groups.
In present study, it was observed that proportion of males 2.66% which were higher than studies by others [7,12,10,13]. Mean age in the present study was 7.43 with SD 4.09 which is slightly higher than study by Haleh et al [9].
In this study most of cases were in age group of 10-14 years (35%), Similar finding was seen in a study by Rajpal et al showed similar results in the age group of 10-14 years (58.18%) [14] .This result is contrary to study done by others in which most cases were between to 5-9 years age group [7,11,15]. Some Studies found most common age is 0-4 years [13,16]. In the present study, all cases were 36% in 0-4 years age group and found similar numbers in 5-9 years of age group]