Second malignant neoplasms after childhood non-central nervous system embryonal tumours in North America: A population-based study

Zong, Xuchen; Pole, Jason D.; Grundy, Paul E.; Mahmud, Salaheddin M.; Parker, Louise; Hung, Rayjean J.

doi:10.1016/j.ejca.2017.06.035

Cited by 14 publications

(17 citation statements)

References 45 publications

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“…In comparison to the overall SIR of 5.2 estimated here, a population-based SIR of 5.3 has been reported using registry data from the United States and Canada. 20 The greater than expected number of SPMs compared to the general population is primarily linked to the late effects of treatment, including alkylating agents, topoisomerase II inhibitors, platinum compounds and radiotherapy. 5 Indeed, treatment intensity has a clear effect on the likelihood of developing a SPM, with Applebaum et.…”

Section: Discussionmentioning

confidence: 99%

Incidence and outcomes of neuroblastoma in Australian children: A population‐based study (1983–2015)

Youlden

Jones

Cundy

et al. 2020

J Paediatrics Child Health

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Background: Neuroblastoma predominantly affects younger children and exhibits heterogeneous behaviour. This study describes incidence and outcomes for neuroblastoma using national population-based data from the Australian Childhood Cancer Registry. Methods:Deidentified data for all children (0-14 years) diagnosed with neuroblastoma and ganglioneuroblastoma from 1983-2015 were extracted. Cause-specific (CSS) and event-free (EFS) survival were estimated using the cohort method. Adjusted hazard ratios (HRs) were calculated using a multivariable flexible parametric survival model. Other outcomes investigated included recurrence and second primary malignancies (SPMs). Results:The study cohort comprised 1,269 patients. Age-standardised incidence rates remained steady across the study period at approximately 9.5 per million children per year.The proportion of patients with metastatic disease at diagnosis decreased from 63% in 1983-1995 to 42% by 2006-2015 (p<0.001). CSS and EFS both improved significantly over time and reached 75% (95% CI=71%-79%) and 71% (95% CI=66%-75%) at 5 years postdiagnosis, respectively, for children diagnosed between 2004-2013. Of patients achieving full remission, 28% relapsed with subsequent 5-year CSS of only 20%. Although SPMs were rare, neuroblastoma survivors carried a 5-fold increased risk compared to cancer rates in the general population (standardised incidence ratio [SIR]=5.18, 95% CI=3.01-8.91), with 7 of the 13 patients (54%) who were diagnosed with an SPM dying within 5 years. Conclusions: CSS for childhood neuroblastoma has improved substantially over time inAustralia, but still remains lower than for most other types of childhood cancer. SPMs are uncommon and carry a better prognosis than relapse of the primary tumour.

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Section: Discussionmentioning

confidence: 99%

Incidence and outcomes of neuroblastoma in Australian children: A population‐based study (1983–2015)

Youlden

Jones

Cundy

et al. 2020

J Paediatrics Child Health

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“…However, B&P RMS survivors commonly experience treatment side-effects, such as: urinary incontinence, recurrent UTIs, decreased renal function, infertility and secondary malignancies. [12][13][14] Therefore, the modern therapy of B&P RMS is aimed at preserving the bladder and sexual function. In most cases the upfront biopsy followed by aggressive CHT, radiotherapy and, if necessary, delayed surgery of the residual tumor mass is preferred to avoid cysto-prostatectomy.…”

Section: Discussionmentioning

confidence: 99%

Delayed diagnosis of pediatric bladder and prostate rhabdomyosarcoma – causes and consequences

et al. 2021

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Introduction: Pediatric rhabdomyosarcoma (RMS) is a rare disease, affecting 4.5-6.0 per 1 000 000 children a year. Bladder and/or prostate (B&P) is the primary tumor site in approximately 10% of patients. Initial symptoms of B&P RMS in children may mimic more common, benign conditions such as urinary tract infections (UTIs), functional disorders, and congenital anomalies of the urinary tract. Aim: The study aims to emphasize the role of careful clinical examination and strict following the diagnostic guidelines in early detection of pediatric B&P RMS in primary care and emergency department settings. Case study: We present two male patients aged 2.5 and 3 years with embryonal B&P RMS initially manifesting as atypical and/or recurrent UTI. In both children, proper diagnoses were delayed due to careless physical examination and failure to adhere to the current guidelines for UTI management. Despite symptoms of an atypical and severe course of UTI, no imaging examinations had been performed for several weeks until dramatic deteriorations of patients’ general conditions occurred. Results and discussion: The prolonged diagnostic processes caused unnecessary suffering of both children and significant delay of oncological treatment in one. In the latter patient, bladder preservation was not possible, resulting in decreased quality of life. Conclusions: Due to its rarity, B&P RMS is infrequently included in the differential diagnosis in children with recurrent or atypical UTI. However, thorough physical examination and adherence to the guidelines of UTI management enable timely diagnosis of underlying malignancy. Early diagnosis of B&P RMS leads to a better prognosis, less intensive treatment, and improved quality of life of B&P RMS survivors.

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“…Comparing our findings with others is complicated by methodological differences. Others have limited their cohorts to those surviving from 6 months to 5 years after their initial cancer diagnosis [5,6,[29], [30], [31], [32], [33], [34]]; required cohort consent [5]; used more dated cohorts diagnosed prior to 2000 [5,6,32]; included all subsequent cancers [3,5,17,34,35]; included in situ tumours and/or non-melanoma skin cancers and/or all tumours arising in the brain and central nervous system [29,31,33]; relied on self-report to ascertain subsequent cancers [5,33]; and, have rarely acknowledged or discussed the impact of multiple primary reporting rules [6,17,19,35].…”

Section: Discussionmentioning

confidence: 99%

“…Again, additional cancers diagnosed within 60 days of the second cancer were considered part of the diagnostic work-up for the second cancer. Although somewhat arbitrary, a two-month/60 day synchronous period has been used previously [17][18][19] . [16] .…”

Section: Cohort and Cancer Definitionsmentioning

confidence: 99%

Risk of a second cancer in Canadians diagnosed with a first cancer in childhood or adolescence

2019

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BackgroundSecond cancers are an adverse outcome experienced by childhood cancer survivors. We quantify the risk and correlates of a second cancer in Canadians diagnosed with a first cancer prior to age 20 years.MethodsUsing death-linked Canadian Cancer Registry data, a population-based cohort diagnosed with a first cancer between 1992 and 2014, prior to age 20 years, were followed for occurrence of a second cancer to the end of 2014. We estimate standardized incidence ratios (SIR), absolute excess risks (AER), cumulative probabilities, and hazard ratios (HR).Findings22,635 people contributed 204,309•1 person-years of follow-up. Overall risk of a second cancer was 6•5 (95% CI: 5•8–7•1) times greater than expected resulting in an AER of 16•5 (14•4–18•5) cancers per 10,000 person-years and a 4•8% (3•8%–6•0%) cumulative probability of a second cancer at 22•6 years of follow-up. SIRs decreased with increasing age at diagnosis and time since diagnosis; were larger in more recent calendar periods of diagnosis; and varied by type of first cancer. Large SIRs in the first year after diagnosis and in those diagnosed in 2010–2014 were partly associated with changing registry practices. For the whole cohort, factors associated with the hazard of a second cancer included: being female vs. male [HR = 1•439 (95%CI: 1•179–1•760)]; being diagnosed in 2005–2014 vs. 1992–2004 [2•084 (1•598–2•719)]; having synchronous first cancers [4•814 (2•042–9•509)]; and being diagnosed with certain types of cancer. Factors varied, however, by type of first cancer.InterpretationRisks of a second cancer are not equally distributed and can be impacted by changes in registry practice and the methods used to define second cancers.

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Second malignant neoplasms after childhood non-central nervous system embryonal tumours in North America: A population-based study

Cited by 14 publications

References 45 publications

Incidence and outcomes of neuroblastoma in Australian children: A population‐based study (1983–2015)

Incidence and outcomes of neuroblastoma in Australian children: A population‐based study (1983–2015)

Delayed diagnosis of pediatric bladder and prostate rhabdomyosarcoma – causes and consequences

Risk of a second cancer in Canadians diagnosed with a first cancer in childhood or adolescence

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