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Neurocognitive and psychosocial outcomes in adult survivors of childhood soft-tissue sarcoma : A report from the St. Jude Lifetime Cohort

Tonning Olsson, Ingrid LU orcid ; Brinkman, Tara M. ; Wang, Mingjuan ; Ehrhardt, Matthew J. ; Banerjee, Pia ; Mulrooney, Daniel A. ; Huang, I. Chan ; Ness, Kirsten K. ; Bishop, Michael W. and Srivastava, Deokumar , et al. (2020) In Cancer 126(7). p.1576-1584
Abstract

Background: To the authors' knowledge, few studies to date have examined long-term neurocognitive outcomes in survivors of childhood soft-tissue sarcoma. Methods: A total of 150 survivors (41% of whom were female with a mean current age of 33 years [SD, 8.9 years] and a time since diagnosis of 24 years [SD, 8.7 years]) and 349 community controls (56% of whom were female with a mean current age of 35 years [SD, 10.2 years]) completed comprehensive neuropsychological testing, echocardiography, electrocardiography, pulmonary function tests, endocrine evaluation, and physical examination. Patient-reported outcomes of health-related quality of life (HRQOL) and social attainment were collected. Survivors were compared with norms and controls... (More)

Background: To the authors' knowledge, few studies to date have examined long-term neurocognitive outcomes in survivors of childhood soft-tissue sarcoma. Methods: A total of 150 survivors (41% of whom were female with a mean current age of 33 years [SD, 8.9 years] and a time since diagnosis of 24 years [SD, 8.7 years]) and 349 community controls (56% of whom were female with a mean current age of 35 years [SD, 10.2 years]) completed comprehensive neuropsychological testing, echocardiography, electrocardiography, pulmonary function tests, endocrine evaluation, and physical examination. Patient-reported outcomes of health-related quality of life (HRQOL) and social attainment were collected. Survivors were compared with norms and controls on neurocognitive outcomes using general linear models, and on HRQOL and social attainment using modified Poisson models. The impacts of treatment and chronic health conditions on outcomes were examined using multivariable general linear models (effect size was expressed as unstandardized β estimates that reflected the unit of change from a mean of 0 and an SD of 1) and modified Poisson models (effect size expressed as relative risks). Results: Compared with controls and population norms, survivors demonstrated lower performance on measures of verbal reasoning (mean z score, −0.45 [SD, 1.15]; P <.001) mathematics (mean z score, −0.63 [SD, 1.07]; P <.001), and long-term memory (mean z score, −0.37 [SD, 1.14]; P <.001). Cumulative anthracycline exposure (per 100 mg/m2) was found to be associated with poorer verbal reasoning (β = −0.14 z scores; P =.04), reading (β = −0.09 z score; P =.04), and patient-reported vitality (relative risk, 1.32; 95% CI, 1.09-1.59). Neurologic and neurosensory chronic conditions were associated with poorer mathematics (neurologic conditions: β = −0.63 z score [P = 0.02]; and hearing impairment: β = −0.75 z scores [P < 0.01]). Better cognitive performance was associated with higher social attainment. Conclusions: Long-term survivors of soft-tissue sarcoma are at risk of neurocognitive problems and poor HRQOL associated with anthracycline treatment and chronic health conditions.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
anthracycline and cognition, childhood soft-tissue sarcoma, health-related quality of life (HRQOL), neurocognition, survivorship
in
Cancer
volume
126
issue
7
pages
1576 - 1584
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:31913509
  • scopus:85077843468
ISSN
0008-543X
DOI
10.1002/cncr.32694
language
English
LU publication?
no
id
07b756ad-84fd-4b49-baf7-8f81c1f2a072
date added to LUP
2020-01-31 16:18:35
date last changed
2024-06-12 08:12:07
@article{07b756ad-84fd-4b49-baf7-8f81c1f2a072,
  abstract     = {{<p>Background: To the authors' knowledge, few studies to date have examined long-term neurocognitive outcomes in survivors of childhood soft-tissue sarcoma. Methods: A total of 150 survivors (41% of whom were female with a mean current age of 33 years [SD, 8.9 years] and a time since diagnosis of 24 years [SD, 8.7 years]) and 349 community controls (56% of whom were female with a mean current age of 35 years [SD, 10.2 years]) completed comprehensive neuropsychological testing, echocardiography, electrocardiography, pulmonary function tests, endocrine evaluation, and physical examination. Patient-reported outcomes of health-related quality of life (HRQOL) and social attainment were collected. Survivors were compared with norms and controls on neurocognitive outcomes using general linear models, and on HRQOL and social attainment using modified Poisson models. The impacts of treatment and chronic health conditions on outcomes were examined using multivariable general linear models (effect size was expressed as unstandardized β estimates that reflected the unit of change from a mean of 0 and an SD of 1) and modified Poisson models (effect size expressed as relative risks). Results: Compared with controls and population norms, survivors demonstrated lower performance on measures of verbal reasoning (mean z score, −0.45 [SD, 1.15]; P &lt;.001) mathematics (mean z score, −0.63 [SD, 1.07]; P &lt;.001), and long-term memory (mean z score, −0.37 [SD, 1.14]; P &lt;.001). Cumulative anthracycline exposure (per 100 mg/m<sup>2</sup>) was found to be associated with poorer verbal reasoning (β = −0.14 z scores; P =.04), reading (β = −0.09 z score; P =.04), and patient-reported vitality (relative risk, 1.32; 95% CI, 1.09-1.59). Neurologic and neurosensory chronic conditions were associated with poorer mathematics (neurologic conditions: β = −0.63 z score [P = 0.02]; and hearing impairment: β = −0.75 z scores [P &lt; 0.01]). Better cognitive performance was associated with higher social attainment. Conclusions: Long-term survivors of soft-tissue sarcoma are at risk of neurocognitive problems and poor HRQOL associated with anthracycline treatment and chronic health conditions.</p>}},
  author       = {{Tonning Olsson, Ingrid and Brinkman, Tara M. and Wang, Mingjuan and Ehrhardt, Matthew J. and Banerjee, Pia and Mulrooney, Daniel A. and Huang, I. Chan and Ness, Kirsten K. and Bishop, Michael W. and Srivastava, Deokumar and Robison, Leslie L. and Hudson, Melissa M. and Krull, Kevin R.}},
  issn         = {{0008-543X}},
  keywords     = {{anthracycline and cognition; childhood soft-tissue sarcoma; health-related quality of life (HRQOL); neurocognition; survivorship}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{7}},
  pages        = {{1576--1584}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Cancer}},
  title        = {{Neurocognitive and psychosocial outcomes in adult survivors of childhood soft-tissue sarcoma : A report from the St. Jude Lifetime Cohort}},
  url          = {{http://dx.doi.org/10.1002/cncr.32694}},
  doi          = {{10.1002/cncr.32694}},
  volume       = {{126}},
  year         = {{2020}},
}