Background Systematic pain management of children is not enough in China, and there is no summary of pain in children with sarcoma. Methods Collect clinical data of newly diagnosed sarcoma patients admitted to the Medical Oncology Department of Beijing Children’s Hospital from October 2018 to December 2020. Pain assessment was completed by part-time palliative doctors. Children with pain received analgesic treatment and regular assessment. Results A total of 188 newly diagnosed sarcoma patients were included. 37 patients (19.7%) suffered from pain. 6 cases (16.2%) had mild pain, 17 (46.0%) moderate, and 14 (37.8%) severe. The daily life of 31 patients (83.8%) was affected by pain. 26 cases (70.3%) had bone invasion. The analgesic rate was 54.1% (20/37) before admission and 89.2% (33/37) after admission. 9 cases were treated with oral morphine regularly, all of whose pain relieved before chemotherapy, and the actual dose of morphine was 0.14±0.034mg/kgQ4H when the target was reached. No serious adverse reactions were observed. The total time of morphine application after chemotherapy was 5-9 days (median 6 days), and there was no withdrawal reaction during the process of reduction. Conclusion The pain in children with newly diagnosed sarcoma was mainly moderate to severe pain, and the incidence of pain in sarcoma originating from bone or invading bone was higher and the intensity was more severe. Patients who received standardized pain assessment and regular analgesic reached pain relief quickly, and no serious adverse reactions were observed within the recommended dosage.

Objectives: Summarized the clinical characteristics of non-high risk neuroblastoma with spinal canal involvement. Patients and Methods: Retrospective, single center cohort study of non-high risk patients treated for NB (from March first 2007 to June 30th 2019) with intraspinal extension. We used the Kaplan-Meier curve to analyze and describe the prognosis. All patients followed up to April 30th, 2020. Results: 46 patients were included among the 371 patients. Median age was 13 months, median course of disease was 1 month and median follow up time was 39.5 months. The most prevalent initial symptoms were neurological motor and sensory deficit. The primary sites of the patients were posterior mediastinum. There were 19 patients divided in low risk group and others were in middle risk group. None patient died during the follow up time and 2 patients with progression of the primary disease. 24 cases received neurosurgical intervention, 18 patients’ muscle strength can recover gradually. 8 patients who with sphincter dysfunction received laminectomy and all patients recovered normal. There was an obvious improvement for pain of nerve root in the 17 patients. 14 patients with scoliosis before the laminectomy and the operation didn’t cause an aggravation of the condition. Conclusion: There was a short course and young age at diagnosis to the patients. The primary site usually located in posterior mediastinum. The highest prevalence of initial symptom was muscle strength abnormal. Neurological surgery combined with chemotherapy may relieve the symptoms of spinal canal compression effectively, and improve the quality of life.

Objectives: To summarize the clinical characteristics and outcome of infantile extracranial germ cell tumors(GCTs) from four different centers in China since the last 10 years. Methods: Fifteen cases of infantile extracranial GCTs diagnosed between January 1st, 2010 to December 31st, 2019 were evaluated. Results: Nine patients were males(60%) and six were females(40%). The median age was 5.2 months(ranges:2.4-11.8months). There were six cases(40%) in retroperitoneum, six cases(40%) in sacrococcygeal, one case(6.6%) in testicular, one case(6.6%) in hip and one case(6.6%) in mediastinum. Histologically, there were 10 cases(66.6%) of immature teratoma, 3(20%) mixed GCTs and 2(13.3%) malignant GCTs. One case was stageII(6.6%), eleven stageIII(73.3%), one stageIV(6.6%) and two cases were unclear(13.3%). Nine cases(60%) had alpha-fetoprotein(AFP) level of higher than 1000ng/ml. All of the cases received adjuvant chemotherapy in which platinum-based chemotherapy regimens were mostly used. The median follow-up time was 31 months(range: 3–81 months). At the end of treatment, 12 patients got CR(80%), 1 PR(6.7%) and 2 NR(13.3%). During the follow-up period, 12 patients alive without disease and 3 patient who did not got CR at the end of treatment died of disease progression. Conclusions: Most of infantile extracranial GCTs located outside the gonads. Sacrococcygeal and retroperitoneal regions were common sites. Histologically, teratoma was more common in infantile GCTs. Early diagnosis is needed and chemotherapy regimen needs to be further standardized in China. An evaluation system is needed to figure out treatment efficacy and prognosis in the future.

Hepatoblastoma (HB) is the most common liver malignant tumor in childhood and is related to premature delivery and low birth weight. Neonatal necrotizing enterocolitis (NEC) is also related to premature delivery and low birth weight. We report two patients who were diagnosed as hepatoblastoma after having a history of NEC, and they are not common in hepatoblastoma due to their particularity. Premature delivery and low birth weight are the common factors leading to the onset of HB and NEC. The correlation between the two needs further study.