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Hospital admission for neurologic disorders among 5-year survivors of noncentral nervous system tumors in childhood : A cohort study within the Adult Life after Childhood Cancer in Scandinavia study

Kenborg, Line ; Linnet, Karen M. ; de Fine Licht, Sofie ; Bautz, Andrea ; Holmqvist, Anna S. LU ; Tryggvadottir, Laufey ; Madanat-Harjuoja, Laura M. ; Stovall, Marilyn ; Heilmann, Carsten and Albieri, Vanna , et al. (2020) In International Journal of Cancer 146(3). p.819-828
Abstract

Large, comprehensive studies of the risk for neurologic disorders among long-term survivors of noncentral nervous system (CNS) childhood cancers are lacking. Thus, the aim of our study was to assess the lifetime risk of Nordic non-CNS childhood cancer survivors for neurologic disorders. We identified 15,967 5-year survivors of non-CNS childhood cancer diagnosed in Denmark, Iceland, Finland and Sweden in 1943–2008, and 151,118 matched population comparison subjects. In-patient discharge diagnoses of neurologic disorders were used to calculate relative risks (RRs) and absolute excess risks (AERs). A neurologic disorder was diagnosed in 755 of the survivors while 370 were expected, yielding a RR of 2.0 (95% confidence interval (CI)... (More)

Large, comprehensive studies of the risk for neurologic disorders among long-term survivors of noncentral nervous system (CNS) childhood cancers are lacking. Thus, the aim of our study was to assess the lifetime risk of Nordic non-CNS childhood cancer survivors for neurologic disorders. We identified 15,967 5-year survivors of non-CNS childhood cancer diagnosed in Denmark, Iceland, Finland and Sweden in 1943–2008, and 151,118 matched population comparison subjects. In-patient discharge diagnoses of neurologic disorders were used to calculate relative risks (RRs) and absolute excess risks (AERs). A neurologic disorder was diagnosed in 755 of the survivors while 370 were expected, yielding a RR of 2.0 (95% confidence interval (CI) 1.9–2.2). The highest risks were found among survivors of neuroblastoma (4.1; 95% CI 3.2–5.3) and leukemia (2.8; 95% CI 2.4–3.2). The AER decreased from 331 (278–383) excess neurologic disorders per 100,000 person-years 5–9 years after diagnosis to 82 (46–118) ≥ 20 years after diagnosis. Epilepsy was the most common diagnosis (n = 229, 1.4% of all survivors), and significantly increased risks were seen among survivors of eight out of 12 types of childhood cancer. Survivors of neuroblastoma had remarkably high risks (RR ≥ 10) for hospitalization for paralytic syndromes and hydrocephalus, while survivors of leukemia had additional high risks for dementia and encephalopathy. In conclusion, survivors of non-CNS childhood cancer are at high risk for neurologic disorders, especially within the first decade after diagnosis. Therefore, intensive follow-up to identify those who require close management is needed.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
childhood cancer, cohort study, late effects, neurologic disorders
in
International Journal of Cancer
volume
146
issue
3
pages
819 - 828
publisher
John Wiley and Sons
external identifiers
  • scopus:85065169189
  • pmid:30980681
ISSN
0020-7136
DOI
10.1002/ijc.32341
language
English
LU publication?
yes
id
61ea6330-ccdf-4deb-81e0-aa87833bd35a
date added to LUP
2019-05-24 13:32:57
date last changed
2021-04-13 02:09:35
@article{61ea6330-ccdf-4deb-81e0-aa87833bd35a,
  abstract     = {<p>Large, comprehensive studies of the risk for neurologic disorders among long-term survivors of noncentral nervous system (CNS) childhood cancers are lacking. Thus, the aim of our study was to assess the lifetime risk of Nordic non-CNS childhood cancer survivors for neurologic disorders. We identified 15,967 5-year survivors of non-CNS childhood cancer diagnosed in Denmark, Iceland, Finland and Sweden in 1943–2008, and 151,118 matched population comparison subjects. In-patient discharge diagnoses of neurologic disorders were used to calculate relative risks (RRs) and absolute excess risks (AERs). A neurologic disorder was diagnosed in 755 of the survivors while 370 were expected, yielding a RR of 2.0 (95% confidence interval (CI) 1.9–2.2). The highest risks were found among survivors of neuroblastoma (4.1; 95% CI 3.2–5.3) and leukemia (2.8; 95% CI 2.4–3.2). The AER decreased from 331 (278–383) excess neurologic disorders per 100,000 person-years 5–9 years after diagnosis to 82 (46–118) ≥ 20 years after diagnosis. Epilepsy was the most common diagnosis (n = 229, 1.4% of all survivors), and significantly increased risks were seen among survivors of eight out of 12 types of childhood cancer. Survivors of neuroblastoma had remarkably high risks (RR ≥ 10) for hospitalization for paralytic syndromes and hydrocephalus, while survivors of leukemia had additional high risks for dementia and encephalopathy. In conclusion, survivors of non-CNS childhood cancer are at high risk for neurologic disorders, especially within the first decade after diagnosis. Therefore, intensive follow-up to identify those who require close management is needed.</p>},
  author       = {Kenborg, Line and Linnet, Karen M. and de Fine Licht, Sofie and Bautz, Andrea and Holmqvist, Anna S. and Tryggvadottir, Laufey and Madanat-Harjuoja, Laura M. and Stovall, Marilyn and Heilmann, Carsten and Albieri, Vanna and Hasle, Henrik and Winther, Jeanette F.},
  issn         = {0020-7136},
  language     = {eng},
  number       = {3},
  pages        = {819--828},
  publisher    = {John Wiley and Sons},
  series       = {International Journal of Cancer},
  title        = {Hospital admission for neurologic disorders among 5-year survivors of noncentral nervous system tumors in childhood : A cohort study within the Adult Life after Childhood Cancer in Scandinavia study},
  url          = {http://dx.doi.org/10.1002/ijc.32341},
  doi          = {10.1002/ijc.32341},
  volume       = {146},
  year         = {2020},
}