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. 2023 Oct;129(8):1298-1305.
doi: 10.1038/s41416-023-02400-0. Epub 2023 Aug 21.

Surveillance after childhood cancer: are survivors with an increased risk for cardiomyopathy regularly followed-up?

Nicolas Bougas  1 , Rodrigue S Allodji  2   3 , Chiraz Fayech  4 , Nadia Haddy  2   3 , Imene Mansouri  2   3 , Neige Journy  2   3 , Charlotte Demoor  5 , Julie Allard  4 , Eric Thebault  4   6 , Aurore Surun  5 , Hélène Pacquement  5 , Claire Pluchart  7 , Pierre-Yves Bondiau  8 , Delphine Berchery  9 , Anne Laprie  9 , Marjorie Boussac  10   11 , Angela Jackson  2   3 , Vincent Souchard  2   3 , Giao Vu-Bezin  2   3 , Christelle Dufour  4 , Dominique Valteau-Couanet  4 , Florent de Vathaire  2   3 , Brice Fresneau  2   4 , Agnès Dumas  12   2
Affiliations

Surveillance after childhood cancer: are survivors with an increased risk for cardiomyopathy regularly followed-up?

Nicolas Bougas et al. Br J Cancer. 2023 Oct.

Abstract

Background: We aimed to study adherence to cardiac screening in long-term childhood cancer survivors (CCS) at high risk of cardiomyopathy.

Methods: This study involved 976 5-year CCS at high risk for cardiomyopathy from the French Childhood Cancer Survivor Study. Determinants of adherence to recommended surveillance were studied using multivariable logistic regression models. Association of attendance to a long-term follow-up (LTFU) visit with completion of an echocardiogram was estimated using a Cox regression model.

Results: Among participants, 32% had an echocardiogram within the 5 previous years. Males (adjusted RR [aRR] 0.71, 95% CI 0.58-0.86), survivors aged 36-49 (aRR 0.79, 95% CI 0.64-0.98), Neuroblastoma (aRR 0.53, 95% CI 0.30-0.91) and CNS tumour survivors (aRR 0.43, 95% CI 0.21-0.89) were less likely to adhere to recommended surveillance. Attendance to an LTFU visit was associated with completion of an echocardiogram in patients who were not previously adherent to recommendations (HR 8.20, 95% CI 5.64-11.93).

Conclusions: The majority of long-term survivors at high risk of cardiomyopathy did not adhere to the recommended surveillance. Attendance to an LTFU visit greatly enhanced the completion of echocardiograms, but further interventions need to be developed to reach more survivors.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Flow-chart of the patients from the FCCSS cohort included in the present study.
FCCSS French Childhood Cancer Survivor Study.
Fig. 2
Fig. 2. Definition of adherence and long-term adherence to recommended cardiac surveillance for survivors at high risk of cardiomyopathy.
EC echocardiogram.
Fig. 3
Fig. 3. Description of treatment exposures according to the childhood cancer diagnosed in patients at high risk for cardiomyopathy.
CNS central nervous system, LV left ventricular. a Gonadal tumour, thyroid tumour, retinoblastoma and other types of carcinoma.
Fig. 4
Fig. 4. Survivors at high risk of cardiomyopathy included in the Cox regression model to assess whether attending a long-term follow-up visit influenced the subsequent completion of an echocardiogram.
Subjects who were not adherent to recommended surveillance at the time of the LTFU program implementation (2) were included (n = 512), whereas subjects who were not adherent to recommended surveillance at the time of the LTFU program implementation (1) were excluded. EC echocardiogram, LTFU long-term follow-up.
See this image and copyright information in PMC

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