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. 2026 Mar;73(3):e70073.
doi: 10.1002/1545-5017.70073. Epub 2026 Jan 10.

Cognitive and Psychosocial Outcome in Children and Adolescents Treated for Extracranial Malignant Solid Tumors and Lymphomas in the RISK-N Study

Hugo Câmara-Costa  1   2   3 , Zoé Barrault  2   3   4 , Audrey Longaud  4 , Virginie Kieffer  1   4 , Jacques Grill  4 , Mathilde Chevignard  1   2   3 , Nathalie Gaspar  4 , Véronique Minard-Colin  4 , Brice Fresneau  4 , Charlotte Rigaud  4 , Lila Saidoun  4 , Léa Guerrini-Rousseau  4 , Samuel Abbou  4 , Pablo Berlanga  4 , Claudia Pasqualini  4 , Stephanie Bolle  4 , Georges Dellatolas  3 , Christelle Dufour  4
Affiliations

Cognitive and Psychosocial Outcome in Children and Adolescents Treated for Extracranial Malignant Solid Tumors and Lymphomas in the RISK-N Study

Hugo Câmara-Costa et al. Pediatr Blood Cancer. 2026 Mar.

Abstract

Objective: Recent studies show evidence of cognitive and psychosocial impairments and reduced quality of life (QoL) in adult survivors of childhood extracranial solid tumors and lymphomas, but limited research has addressed these issues in pediatric populations.

Study design: The French RISK-N prospective study (2014-2021) evaluated 278 survivors of extracranial solid tumors or lymphomas (47% female, mean age at diagnosis and assessment: 6.2 and 11.7 years). Patients with pre-existing neurological conditions were excluded. Sociodemographic, disease-related, and treatment data were collected. Cognitive performance was assessed using Wechsler Intelligence Scales for Children (WISC-IV, WISC-V). Psychosocial outcomes included parent and/or patient-reported executive functions (Behavior Rating Inventory of Executive Function), behavior (Conner's Parent Rating Scale), QoL (Pediatric Quality of Life Inventory), fatigue (Multidimensional Fatigue Scale), and depression (Children's Depression Inventory). Information on schooling and educational/rehabilitative interventions was also recorded.

Results: Diagnoses included lymphoma (25%), nephroblastoma (19%), neuroblastoma (19%), osteosarcoma (7%), other sarcomas (18%), and other tumors (12%). Mean Full Scale Intellectual Quotient [M(SD) = 99.44(15.62)] was as expected in the general population [M(SD) = 100(15)], but the WISC-IV Perceptual Reasoning Index was slightly lower [M(SD) = 95.4(15.0), <1.5 SD 14%]. Parent- and self-reports indicated greater executive dysfunction, inattention, fatigue, and reduced QoL. In multivariable regression models, poorer cognitive outcomes were associated with lower parental education and developmental/learning delays before diagnosis.

Conclusions: Objective cognitive deficits were uncommon among pediatric cancer survivors, contrasting with a relatively high level of subjective cognitive and psychosocial complaints, highlighting the need for systematic screening and tailored clinical interventions.

Keywords: intellectual quotient; lymphomas; neurocognitive outcome; pediatric extracranial solid tumors; psychosocial outcome.

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