Incidence of and Risk Factors for Histologically Confirmed Solid Benign Tumors Among Long-term Survivors of Childhood Cancer
| Autor: | Kok, J.L., Teepen, J.C., Pal, H.J. van der, Leeuwen, F.E. van, Tissing, W.J.E., Neggers, S.J.C.M.M., Loonen, J.J., Louwerens, M., Versluys, B., Heuvel-Eibrink, M. van den, Dulmen-den Broeder, E. van, Jaspers, M.M.W., Santen, H.M. van, Heiden-van der Loo, M. van der, Janssens, G.O., Maduro, J.H., Bruggink, A.H., Jongmans, M.C., Kremer, L.C.M., Ronckers, C.M., Aleman, B.M.P., Berg, M.H. van den, Bresters, D., Caron, H.N., Clement, S.C., Daniels, L.A., Dolsma, W.V., Grootenhuis, M.A., Haasbeek, C.J.A., Hoeben, B.A.W., Hartogh, J.G. den, Hollema, N., Oldenburger, F., Postma, A., Rij, C.M. van, Tersteeg, R.J.H.A., DCOG-LATER Study Grp |
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| Přispěvatelé: | Guided Treatment in Optimal Selected Cancer Patients (GUTS), CCA - Cancer Treatment and quality of life, Amsterdam Reproduction & Development (AR&D), Pediatric surgery, Internal Medicine, Radiotherapy, Graduate School, CCA - Cancer Treatment and Quality of Life, ARD - Amsterdam Reproduction and Development, Medical Informatics, APH - Aging & Later Life, APH - Methodology, Paediatric Oncology, APH - Societal Participation & Health |
| Rok vydání: | 2019 |
| Předmět: |
Oncology
Osteochondroma Adult Male medicine.medical_specialty Cancer Research Adolescent Uterine fibroids Population Benign tumor Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine All institutes and research themes of the Radboud University Medical Center Cancer Survivors SDG 3 - Good Health and Well-being Risk Factors Internal medicine Breast Fibroadenoma medicine Humans Cumulative incidence 030212 general & internal medicine Registries education Child Original Investigation Aged Netherlands education.field_of_study Radiotherapy business.industry Incidence Hazard ratio Cancer 5-YEAR SURVIVORS DCOG-LATER Middle Aged medicine.disease 030220 oncology & carcinogenesis Child Preschool Female business Nanomedicine Radboud Institute for Molecular Life Sciences [Radboudumc 19] NEOPLASMS Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] |
| Zdroj: | Jama Oncology, 5, 5, pp. 671-680 JAMA Oncology, 5(5), 671. American Medical Association JAMA oncology, 5(5), 671-680. AMER MEDICAL ASSOC JAMA Oncology, 5(5), 671-680 JAMA Oncology, 5(5), 671-680. American Medical Association Jama Oncology, 5, 671-680 JAMA oncology, 5(5), 671-680. American Medical Association Kok, J L, Teepen, J C, van der Pal, H J, van Leeuwen, F E, Tissing, W J E, Neggers, S J C M M, Loonen, J J, Louwerens, M, Versluys, B, van den Heuvel-Eibrink, M M, van Dulmen-den Broeder, E, Jaspers, M M W, van Santen, H M, van der Heiden-van der Loo, M, Janssens, G O, Maduro, J H, Bruggink, A H, Jongmans, M C, Kremer, L C M & Ronckers, C C M 2019, ' Incidence of and Risk Factors for Histologically Confirmed Solid Benign Tumors among Long-term Survivors of Childhood Cancer ', JAMA Oncology, vol. 5, no. 5, pp. 671-680 . https://doi.org/10.1001/jamaoncol.2018.6862 |
| ISSN: | 2374-2437 |
| DOI: | 10.1001/jamaoncol.2018.6862 |
| Popis: | IMPORTANC E Survivors of childhood cancer (CCSs) face risk of developing subsequent tumors. Solid benign tumors may be cancer precursors; benign tumors and cancers may share etiologic factors. However, comprehensive data on the risk for solid benign tumors are lacking. OBJECT; VE To quantify the incidence of and treatment-related risk factors for histologically confirmed solid nonskin benign tumors among CCSs.DESIGN, SETTING, AND PARTICIPANTS This record linkage study involves the Dutch Childhood Oncology Group-Long-Term Effects After Childhood Cancer (DCOG-LATER) cohort of 6165 individuals diagnosed with childhood cancer at younger than 18 years from January], 1963, through December 31, 2001, in 7 Dutch pediatric centers and who survived at least 5 years after the diagnosis. Study groups eligible for record linkage from 1990 onward included 5843 CCSs (94.8%) and 883 siblings. Benign tumors were identified from the population-based Dutch histopathology and cytopathology registry (PALGA). Follow-up was completed on May 1, 2015. Data were analyzed from January 1, 1990, through May 1, 2015.MAIN OUTCOMES AND MEASURES Cumulative incidence of any subsequent benign tumor for cohort strata and multivariable Cox proportional hazards regression models (hazard ratios [HRs]) were used to evaluate potential risk factors for 8 major benign tumor subtypes. RESULTS Of the 5843 eligible CC5s (55.9% male), 542 (9.3%) developed a histologically confirmed subsequent benign tumor after a median follow-up of 22.7 years (range, 5.0-52.2 years). Among women, abdominopelvic radiotherapy inferred dose-dependent increased risks for uterine leiomyoma (n = 43) for doses of less than 20 Gy (HR, 1.9; 95% CI, 0.5-7.0), 20 to less than 30 Gy (HR, 3.4; 95% CI, 1.1-10.4), and at least 30 Gy (HR, 5.4; 95% CI, 2.4-12.4) compared with no abdominopelvic radiotherapy (P =.002 for trend). High-dose radiotherapy to the trunk was not associated with breast fibroadenoma (n = 45). Of 23 osseous and/or chondromatous neoplasms, 16 occurred among leukemia survivors, including llafter total body irradiation (HR, 37.4; 95% CI, 14.8-94.7). Nerve sheath tumors (n = 55) were associated with radiotherapy (HR at 31years of age, 2.9; 95% CI, 1.5-5.5) and a crude indicator of neurofibromatosis type lor 2 status (HR, 5.6; 95% CI, 2.3-13.7). Subsequent risk for benign tumors was higher than the risks for subsequent nonskin solid malignant neoplasms and for benign tumors among siblings.CONCLUSIONS AND RELEVANCE This record linkage study uses a unique resource for valid and complete outcome assessment and shows that CCSs have an approximately 2-fold risk of developing subsequent benign tumors compared with siblings. Site-specific new findings, including for uterine leiomyoma, osteochondroma, and nervous system tumors, are important to enable early diagnosis; this information will be the first step for future surveillance guidelines that include some benign tumors in CCSs and will provide leads for in-depth etiologic studies. |
| Databáze: | OpenAIRE |
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