MPC Member Publications

This database contains a listing of population studies publications written by MPC Members. Anyone can add a publication by an MPC student, faculty, or staff member to this database; new citations will be reviewed and approved by MPC administrators.

Full Citation

Title: Late Health Outcomes Among Survivors of Wilms Tumor Diagnosed Over Three Decades: A Report From the Childhood Cancer Survivor Study

Citation Type: Journal Article

Publication Year: 2023

ISSN: 1527-7755

DOI: 10.1200/JCO.22.02111

PMID: 36693221

Abstract: PURPOSETo evaluate long-term morbidity and mortality among unilateral, nonsyndromic Wilms tumor (WT) survivors according to conventional treatment regimens.METHODSCumulative incidence of late mortality (a- 5 years from diagnosis) and chronic health conditions (CHCs) were evaluated in WT survivors from the Childhood Cancer Survivor Study. Outcomes were evaluated by treatment, including nephrectomy combined with vincristine and actinomycin D (VA), VA + doxorubicin + abdominal radiotherapy (VAD + ART), VAD + ART + whole lung radiotherapy, or receipt of a- 4 chemotherapy agents.RESULTSAmong 2,008 unilateral WT survivors, 142 deaths occurred (standardized mortality ratio, 2.9, 95% CI, 2.5 to 3.5; 35-year cumulative incidence of death, 7.8%, 95% CI, 6.3 to 9.2). The 35-year cumulative incidence of any grade 3-5 CHC was 34.1% (95% CI, 30.7 to 37.5; rate ratio [RR] compared with siblings 3.0, 95% CI, 2.6 to 3.5). Survivors treated with VA alone had comparable risk for all-cause late mortality relative to the general population (standardized mortality ratio, 1.0; 95% CI, 0.5 to 1.7) and modestly increased risk for grade 3-5 CHCs compared with siblings (RR, 1.5; 95% CI, 1.1 to 2.0), but remained at increased risk for intestinal obstruction (RR, 9.4; 95% CI, 3.9 to 22.2) and kidney failure (RR, 11.9; 95% CI, 4.2 to 33.6). Magnitudes of risk for grade 3-5 CHCs, including intestinal obstruction, kidney failure, premature ovarian insufficiency, and heart failure, increased by treatment group intensity.CONCLUSIONWith approximately 40% of patients with newly diagnosed WT currently treated with VA alone, the burden of late mortality/morbidity in future decades is projected to be lower than that for survivors from earlier eras. Nevertheless, the risk of late effects such as intestinal obstruction and kidney failure was elevated across all treatment groups, and there was a dose-dependent increase in risk for all grade 3-5 CHCs by treatment group intensity.

Url: https://pubmed.ncbi.nlm.nih.gov/36693221/

User Submitted?: No

Authors: Weil, Brent R.; Murphy, Andrew J.; Liu, Qi; Howell, Rebecca M.; Smith, Susan A.; Weldon, Christopher B.; Mullen, Elizabeth A.; Madenci, Arin L.; Leisenring, Wendy M.; Neglia, Joseph P.; Turcotte, Lucie M.; Oeffinger, Kevin C.; Termuhlen, Amanda M.; Mostoufi-Moab, Sogol; Levine, Jennifer M.; Krull, Kevin R.; Yasui, Yutaka; Robison, Leslie L.; Armstrong, Gregory T.; Chow, Eric J.; Armenian, Saro H.

Periodical (Full): Journal of clinical oncology : official journal of the American Society of Clinical Oncology

Issue: 14

Volume: 41

Pages: 2638-2650

Countries:

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