Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Dec 15;57(7):1210-6.
doi: 10.1002/pbc.23090. Epub 2011 Mar 7.

Twenty-five year follow-up of childhood Wilms tumor: a report from the Childhood Cancer Survivor Study

Amanda M Termuhlen  1 , Jean M Tersak, Qi Liu, Yutaka Yasui, Marilyn Stovall, Rita Weathers, Melvin Deutsch, Charles A Sklar, Kevin C Oeffinger, Greg Armstrong, Leslie L Robison, Daniel M Green
Affiliations

Twenty-five year follow-up of childhood Wilms tumor: a report from the Childhood Cancer Survivor Study

Amanda M Termuhlen et al. Pediatr Blood Cancer. .

Abstract

Background: Treatment cures over 90% of children with Wilms tumor (WT) who subsequently risk late morbidity and mortality. This study describes the 25-year outcomes of 5-year WT survivors in the Childhood Cancer Survivor Study (CCSS).

Procedure: The CCSS, a multi-institutional retrospective cohort study, assessed WT survivors (N = 1,256), diagnosed 1970-1986, for chronic health conditions, health status, health care utilization, socioeconomic status, subsequent malignant neoplasms (SMNs), and mortality compared to the US population and a sibling cohort (N = 4,023).

Results: The cumulative incidence of all and severe chronic health conditions was 65.4% and 24.2% at 25 years. Hazard ratios (HR) were 2.0, 95% confidence interval (CI) 1.8-2.3 for grades 1-4 and 4.7, 95%CI 3.6-6.1 for grades 3 and 4, compared to sibling group. WT survivors reported more adverse general health status than the sibling group (prevalence ratio [PR] 1.7; 95%CI 1.2-2.4), but mental health status, socioeconomic outcome, and health care utilization were similar. The cumulative incidence of SMN was 3.0% (95%CI 1.9-4.0%) and of mortality was 6.1% (95%CI 4.7-7.4%). Radiation exposure increased the likelihood of congestive heart failure (CHF) (no doxorubicin-HR 6.6; 95%CI 1.6-28.3; doxorubicin ≤ 250 mg/m(2) -HR 13.0; 95%CI 1.9-89.7; doxorubicin >250 mg/m(2) -HR 18.3; 95%CI 3.8-88.2), SMN (standardized incidence ratio [SIR] 9.0; 95%CI 3.9-17.7 with and 4.9; 95%CI 1.8-10.6 without doxorubicin) and death.

Conclusion: Long-term survivors of WT treated from 1970 to 1986 are at increased risk of treatment related morbidity and mortality 25 years from diagnosis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Figure 2
Figure 2
Figure 3
Figure 3
See this image and copyright information in PMC

References

    1. Green DM. The treatment of stages I-IV favorable histology Wilms' tumor. J Clin Oncol. 2004;22(8):1366–1372. - PubMed
    1. D'Angio GJ, Evans AE, Breslow N, et al. The treatment of Wilms' tumor: Results of the national Wilms' tumor study. Cancer. 1976;38(2):633–646. - PubMed
    1. Oeffinger KC, Mertens AC, Sklar CA, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med. 2006;355(15):1572–1582. - PubMed
    1. Mulrooney DA, Yeazel MW, Kawashima T, et al. Cardiac outcomes in a cohort of adult survivors of childhood and adolescent cancer: A report from the Childhood Cancer Survivor Study. Br Med J. 2009 - PMC - PubMed
    1. Hudson MM, Mertens AC, Yasui Y, et al. Health status of adult long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Jama. 2003;290(12):1583–1592. - PubMed

Publication types

MeSH terms

Substances