Authors
Faten Fdhila Ben Ayed, Ranim Zairi, Mohamed Amine Mansouri, Sarra Ben Ahmed, Rim Amdouni, Elhem Jbebli, Raoui Farhat, Samir Haddad, Samar Rhayem, Monia Khemiri
Published in
La Tunisie medicale. Volume 104. Issue 4. Pages 659-665. May 01, 2026. Epub May 01, 2026.
Abstract
Pediatric cancers represent a major public health challenge, particularly in low- and middle-income countries (LMICs). This study aimed to describe the epidemiological and clinical characteristics of pediatric cancers managed at a reference center in Tunisia, analyze treatment pathways, and identify prognostic factors associated with net survival.
A retrospective, single-center, observational prognostic study was conducted at the Pediatric Oncology Unit (POU) of Béchir Hamza Children's Hospital of Tunis over ten years (January 2012 - December 2021), in accordance with STROBE guidelines. All children diagnosed with cancer before age 16 years were included.
A total of 563 children were included (sex ratio 1.18). Mean age at diagnosis was 4.3 ± 3.8 years (median: 3.0 years). Solid tumors predominated (81%), led by neuroblastoma (23.6%), renal tumors (17.2%), and retinoblastoma (10.7%). Five-year net survival was 69%. Multivariate Cox regression identified four independent prognostic factors: leukemia (HR=3.33, 95% CI: 2.07-5.35, p<0.001), metastatic disease (HR=2.65, 95% CI: 1.92-3.66, p<0.001), relapse (HR=2.74, 95% CI: 1.96-3.82, p<0.001), and residence >100 km from the POU (HR=1.32, 95% CI: 0.97-1.80, p=0.018).
Satisfactory survival outcomes are achievable in resource-limited settings with a well-structured oncology unit. Reducing geographic barriers to care and strengthening early diagnosis remain key priorities to further improve outcomes.
PMID:
42578771
Bibliographic data and abstract were imported from PubMed on 11 Aug 2026.
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