Background/Objectives: Gastrostomy tube (GT) placement plays a vital role in managing children with chronic illnesses who are unable to meet their nutritional needs orally. While its clinical benefits are well established, limited data exist on caregivers’ satisfaction with GT use in Jordan. This study aimed to assess caregivers’ satisfaction and identify factors that influence their experiences by using a validated satisfaction scoring system in which a score greater than 20 indicates a high level of satisfaction. Methods: A cross-sectional study was conducted at Jordan University Hospital, including children under 18 years of age who underwent endoscopic GT insertion between July 2017 and December 2024. Caregivers completed the Structured Satisfaction Questionnaire with Gastrostomy Feeding (SAGA-8), and demographic and clinical data were collected. Statistical analyses explored associations between satisfaction levels and patient-, caregiver-, and healthcare-related factors. Results: A total of 46 caregivers participated. The median satisfaction score was 26.1, surpassing the high satisfaction threshold of 20. Overall, 63% of caregivers expressed satisfaction or high satisfaction with GT feeding, and 82.6% were satisfied with the support provided by the healthcare team. Additionally, 69.5% and 65.2% of caregivers reported improvements in their child’s nutritional status and overall family well-being, respectively. Notably, 89.1% observed a reduction in feeding time, and 84.8% reported fewer respiratory infections following GT placement. Over half of the caregivers (58.7%) indicated that they would have agreed to earlier GT placement if they had been more aware of its benefits. Conclusions: Caregivers reported high satisfaction with GT use, with scores well above the validated threshold indicating high satisfaction. These findings highlight the positive impact of GT placement on children’s health outcomes and family quality of life. Enhancing caregiver education and providing robust healthcare support are crucial to improving the management of children who require GT feeding.

Background: Accurate staging is vital for optimizing outcomes in pediatric rhabdomyosarcoma (RMS). While [¹⁸F]-FDG PET/CT is increasingly utilized, its specific impact on clinical management and its prognostic value compared to conventional imaging (CI) require further evaluation. Methods: In this retrospective single-center study, we reviewed 56 pediatric patients with RMS who underwent [¹⁸F]-FDG PET/CT at our center. Imaging findings were compared with CI (CT/MRI) and correlated with clinical management and survival outcomes. Results: In the total cohort (n = 56), PET/CT demonstrated high concordance with CI for nodal assessment, with an apparent sensitivity of 89.5% and specificity of 94.6%. PET/CT identified skeletal metastases in 5 patients (8.9%) and correctly characterized suspicious pulmonary nodules in one case, though it failed to detect a 0.6 cm lung nodule visualized on chest CT. Notably, PET/CT findings directly altered clinical management in 16.1% of patients (n = 9), primarily through radiotherapy adjustments, including field expansions (n = 4), field reductions (n = 3), and the initiation of previously unplanned radiotherapy (n = 2). At a median follow-up of 33.3 months, an exploratory analysis showed that patients with an SUVmax ≥3.6 had a lower 3-year EFS (57.6% vs. 71.6%; p = 0.51) and OS (60.4% vs. 71.6%; p = 0.63); neither comparison reached statistical significance. Conclusion: [¹⁸F]-FDG PET/CT is a powerful adjunct in pediatric RMS staging, particularly for nodal and skeletal evaluation. Its ability to refine radiotherapy planning in nearly one-sixth of cases underscores its clinical utility. SUVmax is not a validated prognostic or predictive biomarker in pediatric RMS; prospective, adequately powered multicenter studies, ideally incorporating volumetric PET parameters, are needed before any role in risk-stratified therapy can be defined.

Background: Systemic inflammation has been implicated in prognosis of multiple malignancies, yet evidence regarding its role in Wilms Tumor (WT) remains scarce. We investigated the prognostic significance of pre-treatment inflammatory markers in unilateral WT. Methods: We conducted a retrospective analysis of children with unilateral WT treated at our institution between November 2014 and December 2023. Clinical characteristics, treatment, and outcomes were evaluated. Inflammatory markers included a novel pan-immune-inflammation value (PIV), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR). Optimal cut-off values for Event-Free Survival (EFS) and Overall survival (OS) were determined using data-derived optimization to maximize survival curve separation (surv_cutpoint). Cox proportional hazards models were used for survival analysis, while ROC curves were used to calculate AUC values and confirm optimal cut-off points. Results: We included 91 patients (median age: 3.6 years; 62% female), of whom 34% presented with metastasis. Higher EFS was significantly associated with low PIV (cut-off 288.9), low NLR (cut-off 1.1), and high LMR (cut-off 6.3). Similarly, OS was positively associated with lower PIV (HR 8.56 for high PIV, p = 0.038) and lower NLR (HR 4.63 for high NLR, p = 0.043). ROC analysis confirmed their discriminative ability; when evaluated at the unified survival cutpoints, LMR yielded an AUC of 0.692 for 5-year mortality (at cut-off 6.3), while NLR yielded an AUC of 0.671 for 5-year events (at cut-off 1.1). Conclusions: Pre-treatment inflammatory markers demonstrate significant prognostic value in unilateral WT. Elevated NLR and PIV, along with lower LMR, correlate with poorer survival. These accessible biomarkers provide a valuable, low-cost tool for risk assessment. Our optimal thresholds differed from Western adult cohorts, emphasizing the need for population-specific reference intervals in global pediatric oncology.