Endocrinological Analysis of 122 Japanese Childhood Cancer Survivors in a Single Hospital

Abstract

Abstract. With recent improvements in the diagnosis and treatment of cancer, the number of childhood cancer survivors (CCSs) has been increasing in Japan. The importance of quality of life during the lifetime of CCSs has now been recognized, and the late effects of cancer treatments are essential and important issues. In this study we analyzed the endocrinological abnormalities of CCSs by retrospectively evaluating 122 outpatients (62 males and 60 females) who had been referred from pediatric oncologists to our follow-up clinic among 151 CCSs attending our hospital more than two years after their cancer treatment. Follow-up duration varied from 2 to 30 (median 8.0) years. Their average age was 17.3 (range 4-36, median 17.0) years, and 38 patients (31.1%) reached adulthood. Endocrinological abnormalities were found in 82 (67%) of 122 survivors. Gonadal dysfunction was observed in 60 patients (49%). Thirty-nine patients (32%) were short or grew at a slower rate. Twenty-six patients (21%) showed thyroid dysfunction. Other abnormalities were as follows: obesity in 20 patients (16%), leanness in 10 (8%), central diabetes insipidus in 11 (9%) and adrenocortical dysfunction in 9 (7%). Low bone mineral density was observed in 41 (42%) of 98 patients evaluated. These endocrinological abnormalities were caused by the combined effects of cancer itself and various treatments (chemotherapy, radiation therapy, surgery, and hematopoietic stem cell transplantation). Lifetime medical surveillance and continuous follow-up are necessary for CCSs, because treatment-related complications may occur during childhood and many years after the therapy as well. Endocrinologists should participate in long-term follow-up of these survivors in collaboration with pediatric oncologists.

Late effects and quality of life of childhood cancer survivors: Part 1. Impact of stem cell transplantation

“…The cure rates and the quality of cure are very important parameters for CCS. The results of the present study significantly contribute to the published literature because very few studies have comprehensively surveyed the late effects and QOL of CCS after treatment with SCT in Japan [17,18,20].…”

“…The health status and extent of organ damage might affect the health-related quality of life (QOL) of long-term childhood cancer survivors (CCS) [9,10]. Many comprehensive reviews have been published in western countries (USA and Europe) on the late effects in CCS treated with SCT [11][12][13][14][15][16]; however, information on CCS treated with SCT in Asian countries including Japan is hitherto limited [17,18].…”

Low Serum Concentrations of Anti-Müllerian Hormone Are Common in 53 Female Childhood Cancer Survivors

“…Infertility or impaired reproductive outcome is also an important problem for CCSs [8,9]. Our group has reported endocrinological abnormalities in 67% and gonadal dysfunction in 49% of 122 CCSs [10]. Chemotherapy, radiation therapy, and conditioning for hematopoietic stem cell transplantation (HSCT) can damage gonadal germ cells and alter the production of gonadal hormones [11].…”

Endocrine late sequelae in long-term survivors of childhood non-Hodgkin lymphoma

“…In the present study, we found normal BMI and normal percentage fat in NHL survivors. Hypothyroidism, which can contribute to obesity and is reported in survivors, especially after local radiotherapy [49][50][51], did not occur in this group of survivors.…”