No abstract

The COVID-pandemic has shown significant impact on cancer care from early detection, management plan to clinical outcomes of cancer patients. The Asian National Cancer Centres Alliance (ANCCA) has put together the 9 "Ps" as guidelines for cancer programs to better prepare for the next pandemic. The 9 "Ps" are Priority, Protocols and Processes, Patients, People, Personal Protective Equipments (PPEs), Pharmaceuticals, Places, Preparedness, and Politics. Priority: to maintain cancer care as a key priority in the health system response even during a global infectious disease pandemic. Protocol and processes: to develop a set of Standard Operating Procedures (SOPs) and have relevant expertise to man the Disease Outbreak Response (DORS) Taskforce before an outbreak. Patients: to prioritize patient safety in the event of an outbreak and the need to reschedule cancer management plan, supported by tele-consultation and use of artificial intelligence technology. People: to have business continuity planning to support surge capacity. PPEs and Pharmaceuticals: to develop plan for stockpiles management, build local manufacturing capacity and disseminate information on proper use and reduce wastage. Places: to design and build cancer care facilities to cater for the need of triaging, infection control, isolation and segregation. Preparedness: to invest early on manpower building and technology innovations through multisectoral and international collaborations. Politics: to ensure leadership which bring trust, cohesion and solidarity for successful response to pandemic and mitigate negative impact on the healthcare system.

Background: Osteosarcoma is the most common bone malignancy in childhood and adolescence. Despite significant advances in diagnostic and therapeutic modalities, osteosarcoma has generally poor prognosis. Several studies highlighted the prognostic significance of demographic and clinical parameters in the pediatric population. Controversy exists about which obvious factors of mortality in some institutions. Meanwhile, little is known about the overall survival (OS) of pediatric osteosarcoma in Dharmais Cancer Hospital.The aim of this study is to estimate the OS in pediatric osteosarcoma.Methods: This retrospective cohort study enrolled 41 children with osteosarcoma during the period of January 2010-September 2017. Patients were selected using inclusion and exclusion criteria. Overall survival (OS) and patient variables were plotted using Kaplan-Meier.Results: Our result showed that all patients admitted to our hospital in advanced stages (IIB and III). Their median OS was 23 months (12.3-33.7 months) with the survival probability was 29.4%.Conclusions: Median OS of pediatric osteosarcoma in our institution was 23 months and the survival probability was 29.4%. It can be used as evidence showing lack of cancer awareness and early detection in our country.

Epithelioid hemangioma is a rare benign vascular tumor manifested as slow-growing subcutaneous or dermal nodules. A previously therapeutic strategy involved surgical excision and sclerotherapy. However, no standard treatment has been established. Here, we reported an atypical case of epithelioid hemangioma that had a locally aggressive behavior and was successfully treated with everolimus, a rapamycin analog used for cancer therapy. A 1-year-old boy presented with an ulcerated lump in the left palmar region. The imaging test results, confirmed through histopathologic examination, suggested a diagnosis of epithelioid hemangioma. Targeted therapy with everolimus was administered orally because of a minimal response to initial transarterial sclerotherapy. The patient achieved a satisfactory response with a significantly reduced lesion size and improved hand function after a 2-year follow-up. This finding showed that patients with locally aggressive forms of epithelioid hemangioma may significantly benefit from everolimus as a potential targeted therapy.