Late mortality from other diseases following childhood cancer in Australia and the impact of intensity of treatment

2020 ◽  
Author(s):  
Danny R. Youlden ◽  
Thomas S. Walwyn ◽  
Richard J. Cohn ◽  
Hazel E. Harden ◽  
Jason D. Pole ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Late Mortality ◽  
The Impact ◽  
Intensity Of Treatment

Temporal trends in cause-specific late mortality among five-year survivors of childhood cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 10004-10004
Author(s):  
G. T. Armstrong ◽  
Z. Pan ◽  
K. Ness ◽  
D. Srivastava ◽  
L. L. Robison
Keyword(s):  
Cancer Therapy ◽  
Childhood Cancer ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Temporal Trends ◽  
Health Conditions ◽  
Late Mortality ◽  
Primary Disease ◽  
External Causes ◽  
The Impact

10004 Background: Five-year survival rates for childhood cancer have increased over the past 4 decades, increasing the number of long-term survivors. Among 5-yr survivors, the impact of changes in therapy on cause-specific late mortality has not been thoroughly assessed. Methods: Late mortality was evaluated over 3 eras (1974–81, 1982–90, 1991–2000) in 26,643 5-year survivors diagnosed <21 years of age from the SEER population-based registry. Cause-specific mortality was categorized as death from recurrence/progression of primary disease, external causes, and non-recurrence/non-external causes (Non-Recur/Ext) (i.e., deaths from health conditions including sequelae of cancer therapy). Results: All-cause and Recurrence mortality was significantly lower in more recent eras ( Table ). No significant improvement in late mortality attributable to Non-Recur/Ext causes was seen. Additionally, all-cause mortality was significantly lower in more recent eras for 5-year survivors of ALL, AML, Hodgkin, NHL, and CNS tumors, but not neuroblastoma and Ewing's Sarcoma where an increase in cumulative incidence of late mortality was seen in more recent eras. Significant improvement in late mortality from Recurrence by era was seen in most diagnostic groups. Conclusions: All-cause late mortality has improved with more recent eras, attributable to reduced rates of mortality from progression of primary disease (i.e., durable remission). Importantly, however, efforts to reduce the toxicity of more recent therapies have not produced detectable reduction in mortality attributable to other health conditions including sequelae of cancer therapy (non-Recur/Ext causes of death), which would include death from second malignancy, cardiac and pulmonary conditions. Worsening late mortality for 5-year survivors of neuroblastoma and Ewing's sarcoma may be due to improved use of salvage therapies that delay, but do not ultimately prevent death. [Table: see text] No significant financial relationships to disclose.

Late mortality of long-term survivors of childhood cancer.

1997 ◽  
Vol 15 (6) ◽  
pp. 2205-2213 ◽  
Author(s):  
M M Hudson ◽  
D Jones ◽  
J Boyett ◽  
G B Sharp ◽  
C H Pui
Keyword(s):  
Childhood Cancer ◽  
Unintentional Injury ◽  
Initial Therapy ◽  
Primary Malignancy ◽  
Late Mortality ◽  
Risk Of Death ◽  
Survivors Of Childhood Cancer ◽  
The Impact ◽  
Long Term Survivors

PURPOSE To determine the frequency and patterns of late mortality among long-term survivors of childhood cancer. MATERIALS AND METHODS Medical records of patients who survived at least 5 years after the diagnosis of childhood cancer were reviewed to determine the causes of subsequent deaths. Estimated 15-year survival and standardized mortality ratios for deaths from nonneoplastic treatment complications were compared with adjusted United States population estimates. The study included 2,053 patients who had survived > or = 5 years, grouped by treatment eras that reflected increased intensity of therapy and significantly improved survival (early era, 1962 to 1970; recent era, 1971 to 1983). RESULTS There have been 258 subsequent deaths in the 2,053 childhood cancer survivors; 169 occurred 5 to 10 years postdiagnosis and 89 > or = 10 years post diagnosis. For the study period as a whole, deaths were attributed to recurrent primary malignancy in 61% of cases, second malignancy in 20%, nonneoplastic treatment complication in 10%, and unintentional injury/suicide in 8%. Late death from recurrent disease decreased significantly for survivors treated in the recent era (P < .0001), while the risk of death from second malignancies increased, although not statistically significantly (P = .10). Projected 15-year survival estimates for all > or = 5-year survivors in both treatment eras was greater than 90%, but differed from expected rates. CONCLUSION Late mortality from recurrence after treatment for childhood cancer decreases with more effective initial therapy. Prolonged disease-free status is associated with an expected survival that approaches that of the general population for patients treated from 1971 through 1983. The impact of more recent intensified and novel therapies for high-risk patients remains to be determined.

scholarly journals P9 A study to investigate the impact of the COVID-19 pandemic on paediatric cancer patients: an international, multicentre, observational cohort study (COVIDPaedsCancer)

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
◽  
Soham Bandyopadhyay
Keyword(s):  
Cohort Study ◽  
Cancer Treatment ◽  
Childhood Cancer ◽  
Multivariate Logistic Regression Analysis ◽  
Global Health Research ◽  
Cancer Outcomes ◽  
Paediatric Cancer ◽  
Cancer Management ◽  
Anti Cancer ◽  
The Impact

Abstract Introduction Childhood cancers are a leading cause of non-communicable disease deaths for paediatric patients around the world. The COVID-19 pandemic may have impacted on global children’s cancer services, which can have consequences for childhood cancer outcomes. The Global Health Research Group on Children’s Non-Communicable Diseases (Global Children’s NCDs) is currently undertaking the first international study to determine the variation in paediatric cancer management during the COVID-19 pandemic, and the short to medium term impacts on childhood cancer outcomes. Methods and analysis This is a multicentre, international, cohort study that will use routinely collected hospital data in a de-identified and anonymised form. Patients will be recruited consecutively into the study, with a 12 -month follow-up period. Patients will be included if they are below the age of 18 years and undergoing anti-cancer treatment for the following cancers: Acute lymphoblastic leukaemia, Burkitt’s Lymphoma, Hodgkin's lymphoma, Wilms Tumour, Sarcoma, Retinoblastoma, Gliomas, Medulloblastomas and Neuroblastomas. Patients must be newly presented or be undergoing active anti-cancer treatment from the 12th March 2020 to the 12th December 2020. The primary objective of the study is to determine 30- and 90-day all-cause mortality rates. This study will examine the factors that influenced these outcomes. Chi-squared analysis will be used to compare mortality between low and middle-income countries and high-income countries. Multilevel, multivariate logistic regression analysis will be undertaken to identify patient-level and hospital-level factors affecting outcomes with adjustment for confounding factors. Ethics and dissemination At the host centre, this study was deemed to be exempt from ethical committee approval due to the use of anonymised registry data. At other centres, participating collaborators have gained local approvals in accordance with their institutional ethical regulations. Collaborators will be encouraged to present the results locally, nationally, and internationally. The results will be submitted for publication in a peer reviewed journal.

scholarly journals Outcomes for Children and Adolescents With Cancer: Challenges for the Twenty-First Century

2010 ◽  
Vol 28 (15) ◽  
pp. 2625-2634 ◽  
Author(s):  
Malcolm A. Smith ◽  
Nita L. Seibel ◽  
Sean F. Altekruse ◽  
Lynn A.G. Ries ◽  
Danielle L. Melbert ◽  
...  
Keyword(s):  
United States ◽  
Childhood Cancer ◽  
Cancer Mortality ◽  
Lymphoblastic Leukemia ◽  
The United States ◽  
Mortality Rates ◽  
Mortality Data ◽  
Childhood Cancers ◽  
Essential Information ◽  
The Impact

Purpose This report provides an overview of current childhood cancer statistics to facilitate analysis of the impact of past research discoveries on outcome and provide essential information for prioritizing future research directions. Methods Incidence and survival data for childhood cancers came from the Surveillance, Epidemiology, and End Results 9 (SEER 9) registries, and mortality data were based on deaths in the United States that were reported by states to the Centers for Disease Control and Prevention by underlying cause. Results Childhood cancer incidence rates increased significantly from 1975 through 2006, with increasing rates for acute lymphoblastic leukemia being most notable. Childhood cancer mortality rates declined by more than 50% between 1975 and 2006. For leukemias and lymphomas, significantly decreasing mortality rates were observed throughout the 32-year period, though the rate of decline slowed somewhat after 1998. For remaining childhood cancers, significantly decreasing mortality rates were observed from 1975 to 1996, with stable rates from 1996 through 2006. Increased survival rates were observed for all categories of childhood cancers studied, with the extent and temporal pace of the increases varying by diagnosis. Conclusion When 1975 age-specific death rates for children are used as a baseline, approximately 38,000 childhood malignant cancer deaths were averted in the United States from 1975 through 2006 as a result of more effective treatments identified and applied during this period. Continued success in reducing childhood cancer mortality will require new treatment paradigms building on an increased understanding of the molecular processes that promote growth and survival of specific childhood cancers.

scholarly journals How decisive is the number of distal arterial anastomoses in coronary bypass surgery?

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Olivier J. L. Jegaden ◽  
Fadi Farhat ◽  
Margaux P. O. Jegaden ◽  
Amar O. Hassan ◽  
Joel Lapeze ◽  
...  
Keyword(s):  
Arterial Graft ◽  
Complete Revascularization ◽  
Prognosis Factor ◽  
Arterial Grafts ◽  
Term Survival ◽  
Late Mortality ◽  
Vessel Disease ◽  
Diabetes Status ◽  
The Impact ◽  
Late Survival

Abstract Background The benefit of arterial revascularization in coronary surgery remains controversial. The incremental value of additional grafts to the left internal thoracic artery (ITA) has been mainly assessed according to the number of arterial grafts, possibly limiting the detection of its actual impact. We analyzed the influence of the number of distal arterial anastomoses (DAA) performed on late mortality in patients having received from one to three arterial grafts. Methods Retrospective review of 3685 primary isolated coronary artery bypass grafting (CABG) performed from 1989 to 2014 was conducted with a 13-year mean follow-up. One arterial graft (SITA) was used in 969 patients, two arterial grafts, ITA or gastroepiploic artery (GEA), in 1883 patients (BITA: 1644; SITA+GEA: 239), and three arterial grafts in 833 patients (BITA+GEA). Totally, 795 patients (22%) received one DAA, 1142 patients (31%) two, 1337 patients (36%) three, and 411 patients (11%) four or more. A sub-group analysis was done in the 2104 patients with 3-vessel disease who received at least 2 arterial grafts. Results In this series the early mortality was 1.6% and it was not influenced by the surgical technique. Late mortality was significantly influenced by age, gender, heart failure, LV ejection fraction, diabetes status, complete revascularization, number of arterial grafts, number of DAA, both ITA, sequential ITA graft, GEA graft. In multivariable analysis with Cox regression model, the number of DAA was the only technical significant independent prognosis factor of late survival (p < 0.0001), predominant over both ITA, complete revascularization and number of arterial grafts. The impact of the number of DAA on survival was found discriminant from 1 to 3; after 3 there was no more additional effect. In 3-vessel disease patients who received at least 2 arterial grafts, the number of DAA remained a significant independent prognosis factor of late survival (p < 0.0001). Conclusions The number of distal arterial anastomoses is an independent predictor of long-term survival, predominant over the number of arterial grafts and the completeness of the revascularization; higher the number, better the late survival. It is a strong support of the extensive use of arterial grafting in CABG.

scholarly journals Validation of questionnaire-reported chest wall abnormalities with a telephone interview in Swiss childhood cancer survivors

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rahel Kasteler ◽  
Christa Lichtensteiger ◽  
Christina Schindera ◽  
Marc Ansari ◽  
Claudia E. Kuehni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Chest Wall ◽  
Daily Life ◽  
Well Being ◽  
Childhood Cancer Survivors ◽  
Thoracic Wall ◽  
Medical Attention ◽  
The Impact

Abstract Background Chest wall abnormalities are a poorly studied complication after treatment for childhood cancer. Chest wall abnormalities are not well-described in the literature, and little is known on the impact on daily life of survivors. Methods We investigated prevalence and risk factors of chest wall abnormalities in childhood cancer survivors in a nationwide, population-based cohort study (Swiss Childhood Cancer Survivor Study) with a questionnaire survey. We then interviewed a nested sample of survivors to validate types of chest wall abnormalities and understand their impact on the daily life of survivors. Results Forty-eight of 2382 (95%CI 2–3%) survivors reported a chest wall abnormality. Risk factors were older age at cancer diagnosis (16–20 years; OR 2.5, 95%CI 1.0–6.1), lymphoma (OR 3.8, 95%CI 1.2–11.4), and central nervous system tumors (OR 9.5, 95%CI 3.0–30.1) as underlying disease, and treatment with thoracic radiotherapy (OR 2.0, 95%CI 1.0–4.2), surgery to the chest (OR 4.5, 95%CI 1.8–11.5), or chemotherapy (OR 2.9, 95%CI 1.0–8.1). The nature of the chest wall abnormalities varied and included thoracic wall deformities (30%), deformations of the spine (5%) or both (55%), and scars (10%). Chest wall abnormalities affected daily life in two thirds (13/20) of those who reported these problems and necessitated medical attention for 15 (75%) survivors. Conclusion It is important that, during follow-up care, physicians pay attention to chest wall abnormalities, which are rare late effects of cancer treatment, but can considerably affect the well-being of cancer survivors.

scholarly journals Enduring Cell Lines: Parents’ Experiences of Postmortem Tumor Banking in Childhood Cancer

2021 ◽  
pp. 107484072110014
Author(s):  
Nancy J. Moules ◽  
Catherine M. Laing ◽  
Wendy Pelletier ◽  
Gregory M. T. Guilcher ◽  
Jennifer A. Chan
Keyword(s):  
Childhood Cancer ◽  
Pediatric Oncology ◽  
Common Factors ◽  
Living Cells ◽  
The Past ◽  
The Family ◽  
Deceased Donors ◽  
Cure Rates ◽  
The Impact ◽  
Parents Experiences

While cure rates in pediatric oncology have improved over the past 30 years, childhood cancer remains the second leading cause of death in children aged 1 to 14. Developing therapies often require using cancerous tissues, which may come from deceased donors. Tumor banks collect, store, and distribute these donated samples. While tumor banking is more common, factors that contribute to parents’ decision and the impact of it on the family are not well understood. The purpose of this hermeneutic study was to understand the meaning and impact of tumor banking for parents of children who have died from cancer. Findings suggest that parents donating their child’s tumors unexpectedly found a sense of meaning in their loss. They also found a legacy of their child’s life; the living cells in some ways assisted the parents with grief. Aspects of this sensitive conversation and decision are discussed from the perspective of the parents’ experiences.

The impact of the written request process on drug development in childhood cancer

2013 ◽  
Vol 60 (4) ◽  
pp. 531-537 ◽  
Author(s):  
Kristen M. Snyder ◽  
Gregory Reaman ◽  
Debbie Avant ◽  
Richard Pazdur
Keyword(s):  
Drug Development ◽  
Childhood Cancer ◽  
The Impact

The impact of CNS-directed treatment on quality of life in childhood cancer survivors

2021 ◽  
Author(s):  
Keagan G. Lipak ◽  
Joseph R. Rausch ◽  
Rachel S. Fisher ◽  
Kemar V. Prussien ◽  
Olivia E. Clark ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Childhood Cancer Survivors ◽  
The Impact

scholarly journals Cycling Through Cancer: Exploring Childhood Cancer Survivors’ Experiences of Well- and Ill-Being

2017 ◽  
Vol 34 (4) ◽  
pp. 345-361 ◽  
Author(s):  
Shaunna M. Burke ◽  
Jennifer Brunet ◽  
Amanda Wurz ◽  
Christina Butler ◽  
Andrea Utley
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Case Analysis ◽  
Childhood Cancer Survivors ◽  
Study Approach ◽  
Multiple Case ◽  
Multiple Domains ◽  
Physical Changes ◽  
Cross Case Analysis ◽  
The Impact

The benefits of informal physical activity during recovery from childhood cancer have rarely been investigated. This study adopted a multiple case study approach to explore the impact of recreational cycling on childhood cancer survivors’ experiences of well- and ill-being. Three semistructured interviews were conducted over a 3-month period with four survivors to explore their experiences of physical, psychological, and social well- and ill-being. Within-case analysis followed by cross-case analysis identified three themes that captured their well- and ill-being experiences with recreational cycling and cancer: (a) cultivating feelings and emotions, (b) experiencing physical changes, and (c) encountering positive and negative social interactions. The results from this study show that recreational cycling may be a useful adjunct to conventional treatments for the self-management of multiple domains of well- and ill-being during recovery from childhood cancer.

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