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Twenty-five year follow-up of childhood Wilms tumor: a report from the Childhood Cancer Survivor Study.
- Source :
-
Pediatric blood & cancer [Pediatr Blood Cancer] 2011 Dec 15; Vol. 57 (7), pp. 1210-6. Date of Electronic Publication: 2011 Mar 07. - Publication Year :
- 2011
-
Abstract
- Background: Treatment cures over 90% of children with Wilms tumor (WT) who subsequently risk late morbidity and mortality. This study describes the 25-year outcomes of 5-year WT survivors in the Childhood Cancer Survivor Study (CCSS).<br />Procedure: The CCSS, a multi-institutional retrospective cohort study, assessed WT survivors (N = 1,256), diagnosed 1970-1986, for chronic health conditions, health status, health care utilization, socioeconomic status, subsequent malignant neoplasms (SMNs), and mortality compared to the US population and a sibling cohort (N = 4,023).<br />Results: The cumulative incidence of all and severe chronic health conditions was 65.4% and 24.2% at 25 years. Hazard ratios (HR) were 2.0, 95% confidence interval (CI) 1.8-2.3 for grades 1-4 and 4.7, 95%CI 3.6-6.1 for grades 3 and 4, compared to sibling group. WT survivors reported more adverse general health status than the sibling group (prevalence ratio [PR] 1.7; 95%CI 1.2-2.4), but mental health status, socioeconomic outcome, and health care utilization were similar. The cumulative incidence of SMN was 3.0% (95%CI 1.9-4.0%) and of mortality was 6.1% (95%CI 4.7-7.4%). Radiation exposure increased the likelihood of congestive heart failure (CHF) (no doxorubicin-HR 6.6; 95%CI 1.6-28.3; doxorubicin ≤ 250 mg/m(2) -HR 13.0; 95%CI 1.9-89.7; doxorubicin >250 mg/m(2) -HR 18.3; 95%CI 3.8-88.2), SMN (standardized incidence ratio [SIR] 9.0; 95%CI 3.9-17.7 with and 4.9; 95%CI 1.8-10.6 without doxorubicin) and death.<br />Conclusion: Long-term survivors of WT treated from 1970 to 1986 are at increased risk of treatment related morbidity and mortality 25 years from diagnosis.<br /> (Copyright © 2011 Wiley Periodicals, Inc.)
- Subjects :
- Adolescent
Adult
Age of Onset
Antineoplastic Agents adverse effects
Child
Child, Preschool
Cohort Studies
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Kidney Neoplasms mortality
Male
Middle Aged
Neoplasms, Second Primary epidemiology
Neoplasms, Second Primary etiology
Radiotherapy adverse effects
Siblings
Survival Analysis
Wilms Tumor mortality
Young Adult
Health Status
Kidney Neoplasms complications
Survivors statistics & numerical data
Wilms Tumor complications
Subjects
Details
- Language :
- English
- ISSN :
- 1545-5017
- Volume :
- 57
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Pediatric blood & cancer
- Publication Type :
- Academic Journal
- Accession number :
- 21384541
- Full Text :
- https://doi.org/10.1002/pbc.23090