Factors Impeding the Timely Pathologic Diagnosis of Malignant Small Round Blue Cell Tumors in a Pediatric Tertiary Care Center in the Philippines: Identifying Opportunities to Optimize Pediatric Cancer Management

OBJECTIVE: This study aimed to evaluate the turnaround time (TAT) of histopathology reports for pediatric small round blue cell tumors (PSRBCTs) at the largest pediatric tertiary care center in the Philippines, and to identify the factors affecting TAT. Additionally, the reasons for the inability to accurately diagnose cases were investigated. METHODS: A retrospective cross-sectional study was conducted on 232 tumor cases from 2018 to 2022. The overall mean TAT, as well as the TAT for specific phases (pre-analytical, analytical, and post-analytical), was determined. Factors contributing to delays in diagnosis were analyzed. Multivariate analysis was used to assess associations between these factors, and Spearman correlation was applied to explore the relationship between the number of consultant pathologists who reviewed a case and the mean TAT. RESULT: The overall mean TAT for PSRBCT histopathology reports was 13.39 days. The pre-analytical, analytical, and post-analytical phases had TATs of 1.89, 11.56, and 4.53 days, respectively. Unavailability of immunohistochemical stains significantly increased TAT (95% CI, p-value < 0.01). A significant reduction in TAT was observed during the COVID-19 pandemic (95% CI, p-value < 0.01). A direct correlation was found between the number of consultant pathologists reviewing a case and the mean TAT (95% CI, p-value < 0.01). The main barrier to rendering a specific diagnosis was the lack of access to molecular tests. CONCLUSION: Prolonged TAT reflects underlying issues that delay the accurate diagnosis of PSRBCTs. The identified deficiencies, including limited access to ancillary tests and specialized expertise, offer opportunities to improve pediatric cancer care in the Philippines.