19 Childhood cancer health outcomes in egypt: ten-year real-world evidence from children’s cancer hospital 57357 – egypt (CCHE) and comparison with results from england

Objectives To study childhood cancer survival and health outcomes over the last ten years in one Egyptian hospital CCHE (Children’s cancer Hospital 57357 Egypt); determine the variations in survival by demographic, cancer type, and disease severity differences and the reasons behind these variations; and compare childhood cancer survival outcomes with results from England. Method A retrospective observational cohort study was conducted for children (age 0-18 years) with confirmed cancer diagnosis who presented at CCHE for treatment from 2007 until 2017 and were followed up until July 2018. Confirmed diagnosis of childhood malignancy followed the WHO/ICCC-3 criteria. Patients’ demographic data were extracted from hospital-based cancer registry, while disease-related and health outcomes data were extracted from hospital disease-specific registry. Health outcomes included 5-year survival rates, age-standardized mortality rates, and trends in disease relapse/progression. Five-year overall survival was calculated for each childhood cancer type using Kaplan Meier analysis. The 5-year overall survival rates at CCHE were compared to population-based 5-year survival of children with cancer in England [2001–2015]. Comparable survival was defined as 10% as inferior survival. Patients’ demographics were described for the full-analysis population, and health outcomes evaluation was done for the evaluable population, based on intention-to-treat analysis. Results A total of 15,997 children with cancer were analyzed; 58% were males and 42% females. Most of the patients (48%) were in the youngest age group [0–4 years]. Fifty-nine percent of patients had solid tumors and 41% had hematologic malignancies. The most common cancers were Leukemia, Lymphoma, CNS tumors, and Neuroblastoma. Survival was calculated for 14,553 patients, representing 92.2% of full study population. 5-year survival rates at CCHE were comparable for some cancer types; 95.6% for Hodgkin’s Lymphoma; 81% for Non-Hodgkin’s Lymphoma; 92.3% for Retinoblastoma; 82% for Renal tumors; 66.4% for CNS tumors; 65.9% for Ewing Sarcoma; 86.9% for Germ cell tumors; 61% for Rhabdomyosarcoma; 77.1% for other soft tissue tumors; and 91.2% for CML. Whereas for other cancer types, overall survival rates at CCHE were inferior; 79.9% for ALL; 53.8% for AML; 56.5% for Neuroblastoma; 56.4% for Hepatoblastoma; 49.1% for Osteosarcoma. Trends in age-adjusted mortality-rates will presented. Conclusions Studying 5-year survival in childhood cancer health outcomes at CCHE would help generate real-world evidence about those having inferior outcomes and identify priority areas that need future improvements. Making better use of the evidence generated at CCHE would enhance real-world practice through making informed decisions that are adapted to a local context setting– CCHE.