Final height and IGF1 in adult survivors of Wilms tumour

Abstract

Objective: One-sided nephrectomy is followed by increased levels of IGF1, associated with linear growth during childhood. The aim was to evaluate final height and IGF1 levels in nephrectomized Wilms tumour survivors when compared with healthy Dutch references and survivors of other cancer types. Design: Cross-sectional retrospective study. Methods: Data of 575 adult childhood cancer survivors were analysed. Median follow-up time was 17.8 (range 5.0-48.8) years. Analysis of (co)variance was performed to evaluate differences between subgroups: nephrectomized Wilms survivors treated with or without abdominal irradiation (nZ41 and nZ36) and survivors of other cancer types treated with or without irradiation involving the cranium, abdomen or total body (nZ149 and nZ349). Main outcome measures were IGF1 and height, expressed as SDS. Results: After adjustment for age at diagnosis, former corticosteroid treatment and renal impairment, height SDS in non-irradiated nephrectomized Wilms survivors was significantly higher than that in non-irradiated survivors of other cancer types (estimated mean SDS K0.09 vs K0.49, PZ0.044), abdominal irradiated survivors (SDS K0.70, PZ0.015) and other irradiated survivors (SDS K1.47, P!0.001). Non-irradiated nephrectomized Wilms tumour survivors had significantly higher IGF1 SDS than other irradiated survivors (estimated mean SDS K0.05 vs K1.36, P!0.001 and 0.11 vs 1.37, P!0.001), while there was no significant difference with the other two subgroups. Conclusions: Adult survivors of Wilms tumour showed better attainment of final height and relatively higher IGF1 levels than those of other cancer types who had significantly shorter stature and lower IGF1 levels than Dutch references.