THE EXPERIENCE OF A SINGLE AUSTRALIAN PEDIATRIC ONCOLOGY UNIT - 1000 PATIENTS 1964-1987

Objective: To determine the survival for children with malignant disea se diagnosed in the period 1964-1987 and treated in a single paediatri c oncology unit.Design: Records of patients treated by the Department of Haematology and Oncology at the Prince of Wales Children's Hospital were reviewed to determine the survival of children with cancer accor ding to decade of diagnosis and diagnostic group. Patients: Patients w ere eligible for the study if referred for treatment at or soon after diagnosis of malignancy. One thousand patients were treated during the study period. There were 363 with acute lymphoblastic leukaemia (ALL) , 126 with tumours of the central nervous system (CNS), 86 with acute non-lymphoblastic leukaemia (ANLL), 81 with lymphoma, 79 with neural c rest tumours, 69 with renal tumours, 66 with bone sarcomas, 53 with so ft tissue sarcomas, and 77 with various other diagnoses. Age range was one day to 20.75 years. Interventions: Treatment included surgery, ra diotherapy and chemotherapy in a variety of protocols. Results: Ten-ye ar survival for the 1960s, 1970s and 1980s was 15%, 51% and 64% respec tively (P < 0.001), excluding tumours of the CNS. From 1985 onwards, a ctual survival at five years has been 79%. Survival from Wilms' tumour and Hodgkin's disease remained high throughout the study period, and significant improvement in survival occurred with ALL, non-Hodgkin's l ymphoma (NHL) and osteogenic sarcoma. Survival remained poor with neur oblastoma and ANLL. Conclusions: Significant improvement in outcomes f or childhood malignancy has been achieved over the last three decades, with five-year survival currently at 79% (excluding tumours of the CN S). Some diagnostic groups have had only small improvements in outcome and require new strategies.