Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Neurocognitive outcomes in long-term survivors of Wilms tumor : a report from the St. Jude Lifetime Cohort

Tonning Olsson, Ingrid LU orcid ; Brinkman, Tara M. ; Hyun, Geehong ; Banerjee, Pia ; Mulrooney, Daniel A. ; Huang, I. Chan ; Green, Daniel M. ; Srivastava, Deokumar ; Robison, Leslie L. and Hudson, Melissa M. , et al. (2019) In Journal of Cancer Survivorship 13(4). p.570-579
Abstract

Purpose: To examine prevalence and predictors of neurocognitive outcomes, social attainment, emotional distress, and health-related quality of life (HRQOL) in long-term survivors of pediatric Wilms tumor (WT). Methods: One hundred fifty-eight WT survivors (59% female; mean [SD] age 33 [9.1] years; time since diagnosis 29 [9.1] years) and 354 community controls (55.6% female; 35 [10.2] years) completed comprehensive neuropsychological testing and physical examination, including echocardiography/electrocardiography, pulmonary function tests, and endocrine evaluation. Self-report of emotional distress, HRQOL, and social attainment were collected. Impairment was defined in relation to both controls and normative data. Generalized linear... (More)

Purpose: To examine prevalence and predictors of neurocognitive outcomes, social attainment, emotional distress, and health-related quality of life (HRQOL) in long-term survivors of pediatric Wilms tumor (WT). Methods: One hundred fifty-eight WT survivors (59% female; mean [SD] age 33 [9.1] years; time since diagnosis 29 [9.1] years) and 354 community controls (55.6% female; 35 [10.2] years) completed comprehensive neuropsychological testing and physical examination, including echocardiography/electrocardiography, pulmonary function tests, and endocrine evaluation. Self-report of emotional distress, HRQOL, and social attainment were collected. Impairment was defined in relation to both controls and normative data. Generalized linear models were developed to examine impact of treatment and chronic health conditions on outcomes. Results: WT survivors performed poorer than norms and controls in 6 of 16 cognitive variables and 1 of 8 HRQOL variables, with scores ranging from − 0.64 (mathematics) to − 0.21 (verbal fluency) standard deviations below expectations. Compared to controls, WT survivors were less likely to graduate college (odds ratio 2.23, 95% confidence interval 1.46–3.41) and had more moderate to severe neurologic conditions (18.4% vs 8.2%, p < 0.001), which were associated with poor memory (β = − 0.90, p < 0.001), attention (β = − 1.02, p < 0.001), and HRQOL general health (β = − 0.80, p = 0.0015). Treatment variables and cardiopulmonary morbidity (higher in survivors) were not associated with outcomes. Conclusions: Survivors of WT demonstrate impairment in neurocognitive function and have lower social attainment during adulthood, with poorer neurocognitive function associated with neurologic morbidity. Implications for Cancer Survivors: Survivors of WT should be offered neurocognitive evaluations and rehabilitation. Neurologic conditions should be routinely assessed, and appropriate support offered to reduce risk for functional limitations.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; and (Less)
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Emotional distress, Health-related quality of life, Neurocognition, Pediatric Wilms tumor, Social attainment
in
Journal of Cancer Survivorship
volume
13
issue
4
pages
570 - 579
publisher
Springer
external identifiers
  • scopus:85068230585
  • pmid:31243647
ISSN
1932-2259
DOI
10.1007/s11764-019-00776-8
language
English
LU publication?
no
id
20f518d3-e989-44ab-b0e3-b00823e2b1a1
date added to LUP
2020-01-31 16:20:00
date last changed
2024-06-26 10:16:07
@article{20f518d3-e989-44ab-b0e3-b00823e2b1a1,
  abstract     = {{<p>Purpose: To examine prevalence and predictors of neurocognitive outcomes, social attainment, emotional distress, and health-related quality of life (HRQOL) in long-term survivors of pediatric Wilms tumor (WT). Methods: One hundred fifty-eight WT survivors (59% female; mean [SD] age 33 [9.1] years; time since diagnosis 29 [9.1] years) and 354 community controls (55.6% female; 35 [10.2] years) completed comprehensive neuropsychological testing and physical examination, including echocardiography/electrocardiography, pulmonary function tests, and endocrine evaluation. Self-report of emotional distress, HRQOL, and social attainment were collected. Impairment was defined in relation to both controls and normative data. Generalized linear models were developed to examine impact of treatment and chronic health conditions on outcomes. Results: WT survivors performed poorer than norms and controls in 6 of 16 cognitive variables and 1 of 8 HRQOL variables, with scores ranging from − 0.64 (mathematics) to − 0.21 (verbal fluency) standard deviations below expectations. Compared to controls, WT survivors were less likely to graduate college (odds ratio 2.23, 95% confidence interval 1.46–3.41) and had more moderate to severe neurologic conditions (18.4% vs 8.2%, p &lt; 0.001), which were associated with poor memory (β = − 0.90, p &lt; 0.001), attention (β = − 1.02, p &lt; 0.001), and HRQOL general health (β = − 0.80, p = 0.0015). Treatment variables and cardiopulmonary morbidity (higher in survivors) were not associated with outcomes. Conclusions: Survivors of WT demonstrate impairment in neurocognitive function and have lower social attainment during adulthood, with poorer neurocognitive function associated with neurologic morbidity. Implications for Cancer Survivors: Survivors of WT should be offered neurocognitive evaluations and rehabilitation. Neurologic conditions should be routinely assessed, and appropriate support offered to reduce risk for functional limitations.</p>}},
  author       = {{Tonning Olsson, Ingrid and Brinkman, Tara M. and Hyun, Geehong and Banerjee, Pia and Mulrooney, Daniel A. and Huang, I. Chan and Green, Daniel M. and Srivastava, Deokumar and Robison, Leslie L. and Hudson, Melissa M. and Krull, Kevin R.}},
  issn         = {{1932-2259}},
  keywords     = {{Emotional distress; Health-related quality of life; Neurocognition; Pediatric Wilms tumor; Social attainment}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{4}},
  pages        = {{570--579}},
  publisher    = {{Springer}},
  series       = {{Journal of Cancer Survivorship}},
  title        = {{Neurocognitive outcomes in long-term survivors of Wilms tumor : a report from the St. Jude Lifetime Cohort}},
  url          = {{http://dx.doi.org/10.1007/s11764-019-00776-8}},
  doi          = {{10.1007/s11764-019-00776-8}},
  volume       = {{13}},
  year         = {{2019}},
}