Outcome of children with Hodgkin's disease. A 10-year experience from a single institution in Kuwait.

OBJECTIVE: To evaluate the outcome of children with Hodgkin's disease over a period of 10-years from a single institution in Kuwait. METHODS: Sixty-three children with previously untreated Hodgkin's disease, who were diagnosed at the Pediatric Oncology Unit of Kuwait Cancer Control Centre, Shuwaikh, Kuwait from January 1998 to December 2007 were included in the study. All cases were proved by histopathology, and staging was carried out according to the Ann Arbor system. RESULTS: Our series included 37 (59%) males and 26 (41%) females with a median age of 10 years (range 3-15 years). B symptoms were present in 20 (32%) children. Bulky disease was noted in 28 (44%) children, with stages III in 8 (13%) and IV in 12 (19%) children. Chemotherapy was administered as a primary treatment in 63 children. The median number of chemotherapy cycles given was 6 (range 2-8). Radiotherapy was used in 40 (63%) children. Grade III hematological toxicity was observed in 23 (37%) and grade IV in 14 (22%) children. Hypothyroidism was observed in 20 (32%) children. Fifty-five children achieved a complete remission (87%) and 2 children achieved a partial remission (3%) with an overall response rate of 90%. Three children achieved a progressive disease (5%) and response could not be evaluated in 3 (5%) children. At a median follow-up of 67 months (5.5 years), the overall survival was 91%. CONCLUSION: With moderate toxicity, combined modality therapy is effective in the treatment of childhood Hodgkin's disease.

Multidisciplinary approach to breast cancer management in Kuwait, 1993-1998.

BACKGROUND AND OBJECTIVES: In Kuwait, breast cancer is the most common form of cancer among women. The present study reviews the clinical features, treatment methods and treatment results of breast cancer patients registered in the Kuwait Cancer Control Center (KCCC) and compares these features with those reported in other Arab countries, Europe and North America. MATERIAL AND METHODS: The present study examines 823 patients with breast cancer who were registered in the KCCC from 1993 to 1998. Patients were identified through the Kuwait Cancer Registry and their cases were followed for at least five years. RESULTS: Eleven males accounted for 1.3% of all patients. The average age was one decade younger than that reported in western countries but similar to reports from Egypt and GCC countries. Surgery was applied in 90.4% of patients. Breast conservation (lumpectomy and axillary clearance) was performed in 19.6% of patients, while mastectomy and axillary clearance was adopted in 60.8%. Radiotherapy was applied in 67.7% of patients and chemotherapy in 60.8%. The long-term overall survival and disease-free survival amounted to 76+/-6.4% and 54+/-4.6% respectively. Prognostic factors were analyzed using univariate and multivariate analysis. According to multivariate analysis the nodal status, the number of involved nodes and histopathology were independent prognostic factors. Comparable results were achieved after both breast conservation and mastectomy. CONCLUSIONS: Since breast conservation protocols yield results similar to mastectomy, its use should be extended. Search for biological prognostic indicators should continue for their potential use as guides for treatment decisions.