המידע באדיבות מדיקונטקסט
Last Updated: 2001-07-16 17:31:05 EDT (Reuters Health)
WESTPORT, CT (Reuters Health) – Improvements in the treatment of childhood cancers have led to a decrease in mortality in recent years, but these patients still have an excess long-term mortality risk compared with the general population, according to the findings of two studies published in the July 1st issue of the Journal of Clinical Oncology.
In one study, Dr. Torgil R. Moller, from the University Hospital, in Lund, Sweden, and colleagues assessed the mortality rates of 13,711 patients who were diagnosed with childhood or adolescent cancer between 1960 and 1989 and who survived at least 5 years from the time of diagnosis. The investigators used data from cancer registries in Denmark, Finland, Iceland, Norway and Sweden.
The standardized mortality ratio (SMR) indicated a 10.8-fold excess in overall mortality, with most of the deaths attributable to a recurrence of the primary cancer, the authors note. The SMR for a second cancer and noncancer death was 4.9 and 3.1, respectively.
Late mortality rates were significantly lower in patients diagnosed between 1980 and 1989 compared with those diagnosed between 1960 and 1979 and no increase in rates of death due to cancer treatment were noted, the researchers point out.
Dr. Ann C. Mertens, from the University of Minnesota, in Minneapolis, and colleagues performed a similar study of 20,227 participants in the US-based Childhood Cancer Survivor Study who were diagnosed with a childhood or adolescent cancer between 1970 and 1986.
The overall SMR was the same as in the first study and the leading cause of death was also recurrence of the primary tumor. The risk of death was significantly higher in females, patients diagnosed before 5 years of age, and in those diagnosed with a central nervous system tumor or leukemia, the authors state. As in the first study, second cancers and noncancer etiologies did account for significant excess mortality rates.
In contrast to findings from the first study, treatment-related complications were linked to significant excesses in mortality risk up to 25 years after the initial cancer diagnosis.
"Many findings in the two studies are similar, if not identical," Dr. Joseph V. Simone, from the Huntsman Cancer Foundation and Institute, in Salt Lake City, comments in a related editorial. He adds that "the data examined and the conclusions differ somewhat, but the studies nicely complement one another."
Dr. Simone believes that "the change in therapy between 1960 and 1970 to a more aggressive, multiagent model was substantial and may account" for the different conclusions reached by the two studies.
J Clin Oncol 2001;19:3161-3181.
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