Late mortality and causes of death among 5-year survivors of childhood cancer diagnosed in the period 1960–1999 and registered in the Italian Off-Therapy Registry

Autor: Francesca Bagnasco, Silvia Caruso, Anita Andreano, Maria Grazia Valsecchi, Momcilo Jankovic, Andrea Biondi, Lucia Miligi, Claudia Casella, Monica Terenziani, Maura Massimino, Carlotta Sacerdote, Vera Morsellino, Giovanni Erminio, Alberto Garaventa, Maura Faraci, Concetta Micalizzi, Maria Luisa Garrè, Marta Pillon, Giuseppe Basso, Eleonora Biasin, Franca Fagioli, Roberto Rondelli, Andrea Pession, Franco Locatelli, Nicola Santoro, Paolo Indolfi, Giovanna Palumbo, Giovanna Russo, Federico Verzegnassi, Claudio Favre, Marco Zecca, Rossella Mura, Paolo D'Angelo, Carmen Cano, Julianne Byrne, Riccardo Haupt, Paolo Pierani, Andreea Pession, Fulvio Porta, Caterina Consarino, Roberta Burnelli, Fausto Fedeli, Monica Cellini, Fiorina Casale, Giuseppe Menna, Patrizia Bertolini, Maurizio Caniglia, Valerio Cecinati, Gabriella Casazza, Roberto Foà, Anna Clerico, Saverio Ladogana, Daniela Galimberti, Marco Rabusin, Luigi Nespoli, Simone Cesaro
Přispěvatelé: Bagnasco, F, Caruso, S, Andreano, A, Valsecchi, M, Jankovic, M, Biondi, A, Miligi, L, Casella, C, Terenziani, M, Massimino, M, Sacerdote, C, Morsellino, V, Erminio, G, Garaventa, A, Faraci, M, Micalizzi, C, Garrè, M, Pillon, M, Basso, G, Biasin, E, Fagioli, F, Rondelli, R, Pession, A, Locatelli, F, Santoro, N, Indolfi, P, Palumbo, G, Russo, G, Verzegnassi, F, Favre, C, Zecca, M, Mura, R, D'Angelo, P, Cano, C, Byrne, J, Haupt, R, Pierani, P, Porta, F, Consarino, C, Burnelli, R, Fedeli, F, Cellini, M, Casale, F, Menna, G, Bertolini, P, Caniglia, M, Cecinati, V, Casazza, G, Foà, R, Clerico, A, Ladogana, S, Galimberti, D, Rabusin, M, Nespoli, L, Cesaro, S
Jazyk: angličtina
Rok vydání: 2019
Předmět:
0301 basic medicine
Male
Pediatrics
Cancer Research
Cardiotoxicity
Causes of death
Childhood cancer
Childhood cancer long-term survivors
Late mortality
Second malignant neoplasms
Oncology
0302 clinical medicine
Cancer Survivors
Cause of Death
Neoplasms
Second malignant neoplasm
Prospective Studies
Registries
Age of Onset
Child
Cause of death
education.field_of_study
Paediatric oncology
Italy
Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA
030220 oncology & carcinogenesis
Child
Preschool

Female
Adult
medicine.medical_specialty
Adolescent
Population
03 medical and health sciences
Young Adult
Age Distribution
medicine
Humans
education
business.industry
Infant
Newborn

Secondary Malignancy
Cancer
Infant
medicine.disease
Confidence interval
030104 developmental biology
Increased risk
Childhood cancer long-term survivor
business
Popis: Introduction Advances in paediatric oncology led to the increase in long-term survival, revealing the burden of therapy-related long-term side effects. We evaluated overall and cause-specific mortality in a large cohort of Italian childhood cancer survivors (CCSs) and adolescent cancer survivors identified through the off-therapy registry. Materials and methods CCSs alive 5 years after cancer diagnosis occurring between 1960 and 1999 were eligible; the last follow-up was between 2011 and 2014. Outcomes were reported as standardised mortality ratios (SMRs) and absolute excess risks (AERs). Results Among 12,214 CCSs, 1113 (9.1%) deaths occurred. Survival at 35 years since diagnosis was 87% (95% confidence interval [CI]: 86–88) and at 45 years was 81% (95% CI: 77–84). CCSs had an 11-fold increased risk of death (SMR 95% CI: 10.7–12), corresponding to an AER of 48 (95% CI: 45–51). Mortality decreased by 60% for survivors treated most recently (1990–1999). The most frequent causes of death were recurrence of the original cancer (56%), a subsequent neoplasm (19%) and cardiovascular diseases (5.8%). Among those who survived at least 15 years after diagnosis, a secondary malignancy was the leading cause of death. Conclusions This study confirms the impact of recent advances in anticancer therapy in reducing mortality, mainly attributable to recurrence but also to other causes. However, overall mortality continues to be higher than in the general population. A long-term follow-up is needed to prevent late mortality due to secondary neoplasms and non-neoplastic causes in CCSs.
Databáze: OpenAIRE