Population-level 5-year event-free survival for children with cancer in Australia.

Autor: Youlden DR; Cancer Council Queensland, Brisbane, Queensland, Australia.; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia., Baade PD; Cancer Council Queensland, Brisbane, Queensland, Australia.; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.; School of Mathematical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia., Gottardo NG; Department of Paediatric and Adolescent Oncology/Haematology, Perth Children's Hospital, Perth, Western Australia, Australia.; Brain Tumour Research Program, Telethon Kids Cancer Centre, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia., Moore AS; Oncology Service, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia.; Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia., Valery PC; Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia., Pole JD; Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia.
Jazyk: angličtina
Zdroj: Pediatric blood & cancer [Pediatr Blood Cancer] 2024 Oct; Vol. 71 (10), pp. e31195. Date of Electronic Publication: 2024 Jul 30.
DOI: 10.1002/pbc.31195
Abstrakt: Background: Event-free survival (EFS) considers other adverse events in addition to mortality. It therefore provides a more complete understanding of the effectiveness and consequences of treatment than standard survival measures, but is rarely reported at the population level for childhood cancer.
Procedure: Our study cohort (n = 7067) was obtained from the Australian Childhood Cancer Registry, including children aged under 15 diagnosed with cancer between 2006 and 2015, with follow-up potentially available to 31 December 2020. The events of interest were relapse following remission, progressive disease, diagnosis of a second primary cancer or death from any cause. Five-year EFS and all-cause observed survival were both calculated, stratified by type of childhood cancer, remoteness of residence and stage at diagnosis. Differences in EFS were assessed using multivariable flexible parametric models.
Results: Approximately one quarter of patients (n = 1605 of 7067, 23%) experienced at least one of the events of interest within 5 years of diagnosis. Relapse was twice as common for children with metastatic/advanced disease (22%) versus children with localised/limited cancers (11%). Overall 5-year EFS was 75.0% (95% confidence interval [CI]: 73.9%-76.0%), compared to 85.8% observed survival (95% CI: 85.0%-86.6%). Patients with other gliomas had the lowest EFS (35.4%, 95% CI: 27.8%-43.1%). EFS was significantly lower among children with acute myeloid leukaemia in outer regional/remote areas compared to major cities (adjusted hazard ratio [HR] = 1.90, 95% CI: 1.20-3.00).
Conclusions: Reporting EFS at a population level provides further insight on a wider range of impacts apart from mortality alone, contributing towards efforts to improve the management and outcomes of childhood cancer.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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