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Tsutsui A, Murakami Y, Okamura S, Fujimaki T, Endo M, Ohno Y. Travel burdens to access care among children with cancer between 2016 and 2019: Analysis of a national population-based cancer registry in Japan. PLoS One 2024; 19:e0300840. [PMID: 38625911 PMCID: PMC11020387 DOI: 10.1371/journal.pone.0300840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/05/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND Centralization of cancer care increases survival but increases the travel burden (i.e., travel durations, distances, and expenditures) in visiting hospitals. This study investigated the travel burdens to access cancer care for children aged 18 years and younger in Japan. METHODS The study population comprised 10,709 patients diagnosed between 2016 and 2019 obtained from a national population-based cancer registry in Japan. Their residences were classified as urban or rural. We counted the number of patients treated at specialized hospitals and investigated the treatment centralization across diagnostic groups by Pareto plot. Travel burdens to access care were estimated using a route-planner web service and summarized using median values. A multivariable logistic model was performed to investigate factors associated with the events of car travel duration exceeding 1 h. RESULTS Of the patients, 76.7% lived in urban areas, and 82.5% received treatment in designated hospitals for childhood cancer. The Pareto plot suggested that the top five hospitals treated 63.5% of patients with retinoblastoma. The estimated travel burdens for all patients were 0.62 h (0.57 h in urban areas and 1.00 h in rural areas), 16.9 km, and 0.0 dollars of toll charges. Regarding travel duration, 21.7% of patients had travel exceeding 1 h, and rural areas, retinoblastoma, malignant bone tumors, and childhood cancer-hub hospitals were associated with travel duration exceeding 1 h (adjusted odds ratios of 6.93, 3.59, 1.94, and 1.91, respectively). CONCLUSIONS Most patients were treated in specialized hospitals and the treatments for specific diseases were centralized. However, most patients were estimated to travel less than 1 h, and the travel burden tended to increase for patients in rural areas, those with specific diseases, and those going to specialized hospitals. Cancer control measures in Japan have steadily improved centralized treatment while keeping the travel burden relatively manageable.
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Affiliation(s)
- Anna Tsutsui
- Department of Medical Statistics, School of Medicine, Toho University, Tokyo, Japan
- Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Department of Medical Innovation, Osaka University Hospital, Suita, Osaka, Japan
| | - Yoshitaka Murakami
- Department of Medical Statistics, School of Medicine, Toho University, Tokyo, Japan
| | - Satomi Okamura
- Department of Medical Innovation, Osaka University Hospital, Suita, Osaka, Japan
| | - Takako Fujimaki
- Division of Information Science, Graduate School of Science and Technology, Nara Institute of Science and Technology, Nara, Japan
| | - Masayuki Endo
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Department of Children’s and Women’s Health, Division of Health Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yuko Ohno
- Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Department of Mathematical Science, Graduate School of Engineering Science, Osaka University, Suita, Osaka, Japan
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Ramirez O, Piedrahita V, Ardila J, Pardo C, Cabrera-Bernal E, Lopera J, Suarez A, Portilla CA, Narváez C, Rodriguez P, Castro X, Castro Á, Estupinan-Perico DI, Valencia D, Álvarez MDR, Fox JE, Bravo LE, Aristizabal P. Primary central nervous system tumors survival in children in ten Colombian cities: a VIGICANCER report. Front Oncol 2024; 13:1326788. [PMID: 38505512 PMCID: PMC10949889 DOI: 10.3389/fonc.2023.1326788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/12/2023] [Indexed: 03/21/2024] Open
Abstract
Purpose Primary central nervous system (CNS) tumors are the second most common cancer in children and adolescents, leading to premature death and disability. Population-based survival estimates aid decision-making in cancer control, however data on survival for primary CNS tumors in Latin America is lacking. We describe survival rates for children with primary CNS tumors treated in ten Colombian cities. Methods We analyzed data from children and adolescents newly diagnosed with cancer between 2012 and 2021, participating in the Childhood Cancer Clinical Outcomes Surveillance System (VIGICANCER) in ten cities in Colombia. VIGICANCER collects information on clinical outcomes from twenty-seven pediatric oncology units and conducts active follow-up every three months. VIGICANCER does not register craniopharyngiomas; we excluded intracranial germ cell tumors for this report. We used the Kaplan-Meier method to estimate the overall survival probability, stratified by sociodemographic variables, topography, WHO grading, receipt of radiation therapy, and type of surgical resection. We analyzed the prognostic capacity of variables using multivariate proportional Cox's regression, stratified by city and year of diagnosis. Results During the study period, VIGICANCER included 989 primary CNS tumors in 879 children and 110 adolescents. The cohort median age was 9 years; 53% of patients were males, and 8% were Afro-descendants. Most common tumors were supratentorial astrocytomas (47%), astrocytic tumors (35%), medulloblastomas (20%), ependymomas (11%), and mixed and unspecified gliomas (10%). Five-year overall survival of the entire cohort was 54% (95% CI, 51-58); for supratentorial gliomas, WHO grade I was 77%, II was 62%, III-IV was 27%, respectively, and for medulloblastoma was 61%. The adjusted hazard rate ratio for patients with WHO grade III and IV, for those with subtotal resection, for brainstem location, and for those not receiving radiation therapy was 7.4 (95% CI, 4.7-11.8), 6.4 (95% CI, 4.2-9.8), 2.8 (95% 2.1-3.8), 2.0 (95% CI, 1.3-2.8) and 2.3 (95% CI, 1.7-3.0), respectively. Conclusion We found that half of Colombia's children and adolescents with primary CNS tumors survive five years, compared to 70% to 80% in high-income countries. In addition to tumor biology and location, gross total resection was crucial for improved survival in this cohort. Systematic monitoring of survival and its determinants provides empirical data for guiding cancer control policies.
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Affiliation(s)
- Oscar Ramirez
- Unidad de Investigación, Fundación Pediatras Oncólogos y Hematólogos (POHEMA), Cali, Colombia
- Unidad de Oncología y Hematología Pediátrica, Clínica Imbanaco – Grupo Quirón Salud, Cali, Colombia
- Registro Poblacional de Cáncer de Cali – Departamento de Patología, Universidad del Valle, Cali, Colombia
| | - Vivian Piedrahita
- Unidad de Investigación, Fundación Pediatras Oncólogos y Hematólogos (POHEMA), Cali, Colombia
- Unidad de Oncología y Hematología Pediátrica, Clínica Imbanaco – Grupo Quirón Salud, Cali, Colombia
- Escuela de Enfermería, Universidad del Valle, Cali, Colombia
| | - Jesus Ardila
- Unidad de Investigación, Fundación Pediatras Oncólogos y Hematólogos (POHEMA), Cali, Colombia
- Unidad de Oncología y Hematología Pediátrica, Clínica Imbanaco – Grupo Quirón Salud, Cali, Colombia
| | - Carlos Pardo
- Unidad de Oncología y Hematología Pediátrica, Hospital de la Misericordia (HOMI) Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia
- Grupo de Oncología y Hematología Pediátrica Universidad Nacional de Colombia, Bogotá, Colombia
| | - Edgar Cabrera-Bernal
- Unidad de Oncología y Hematología Pediátrica, Hospital de la Misericordia (HOMI) Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia
- Grupo de Oncología y Hematología Pediátrica Universidad Nacional de Colombia, Bogotá, Colombia
| | - John Lopera
- Unidad de Oncología y Hematología Pediátrica, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Amaranto Suarez
- Unidad de Oncología y Hematología Pediátrica, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Carlos Andrés Portilla
- Unidad de Investigación, Fundación Pediatras Oncólogos y Hematólogos (POHEMA), Cali, Colombia
- Unidad de Oncología y Hematología Pediátrica, Clínica Imbanaco – Grupo Quirón Salud, Cali, Colombia
- Departamento de Pediatría, Universidad del Valle, Cali, Colombia
| | - Carlos Narváez
- Unidad de Investigación, Fundación Pediatras Oncólogos y Hematólogos (POHEMA), Cali, Colombia
- Unidad de Oncología y Hematología Pediátrica, Clínica Imbanaco – Grupo Quirón Salud, Cali, Colombia
- Departamento de Pediatría, Universidad del Valle, Cali, Colombia
| | - Pamela Rodriguez
- Unidad de Investigación, Fundación Pediatras Oncólogos y Hematólogos (POHEMA), Cali, Colombia
- Unidad de Oncología y Hematología Pediátrica, Fundación Valle del Lili, Cali, Colombia
| | - Ximena Castro
- Unidad de Investigación, Fundación Pediatras Oncólogos y Hematólogos (POHEMA), Cali, Colombia
- Unidad de Oncología y Hematología Pediátrica, Fundación Valle del Lili, Cali, Colombia
| | - Ángel Castro
- Departamento de Pediatría, Universidad de Cartagena, Unidad de Oncología y Hematología Pediátrica, Clínica Blas de Lezo, Cartagena, Colombia
| | | | - Diana Valencia
- Unidad de Oncología y Hematología Pediátrica: Instituto Médico de Alta Tecnología (IMAT) Oncomédica, Montería, Colombia
| | - María del Rosario Álvarez
- Unidad de Investigación, Fundación Pediatras Oncólogos y Hematólogos (POHEMA), Cali, Colombia
- Unidad de Oncología y Hematología Pediátrica, Hospital Infantil Los Ángeles, Pasto, Colombia
| | - Javier Enrique Fox
- Unidad de Oncología y Hematología Pediátrica, Fundación San Vicente de Paul, Medellín, Colombia
| | - Luis Eduardo Bravo
- Unidad de Investigación, Fundación Pediatras Oncólogos y Hematólogos (POHEMA), Cali, Colombia
- Registro Poblacional de Cáncer de Cali – Departamento de Patología, Universidad del Valle, Cali, Colombia
| | - Paula Aristizabal
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of California, San Diego, San Diego, CA, United States
- Pediatric Hematology/Oncology, Rady Children’s Hospital San Diego, San Diego, CA, United States
- Population Sciences, Disparities and Community Engagement, Moores Cancer Center, University of California, San Diego, San Diego, CA, United States
- Dissemination and Implementation Science Center, Altman Clinical and Translational Research Institute, University of California, San Diego, San Diego, CA, United States
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Nakata K, Matsuda T, Hori M, Sugiyama H, Tabuchi K, Miyashiro I, Matsumoto K, Yoneda A, Takita J, Shimizu C, Katanoda K. Cancer incidence and type of treatment hospital among children, adolescents, and young adults in Japan, 2016-2018. Cancer Sci 2023; 114:3770-3782. [PMID: 37414740 PMCID: PMC10475761 DOI: 10.1111/cas.15892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 07/08/2023] Open
Abstract
Cancer in children, adolescents, and young adults (AYAs) although rare, is the leading disease-specific cause of death in Japan. This study aims to investigate cancer incidence and type of treatment hospital among children and AYAs in Japan. Cancer incidence data (2016-2018) for those aged 0-39 years were obtained from the Japanese population-based National Cancer Registry. Cancer types were classified according to the 2017 update of the International Classification of Childhood Cancer (Third Edition), and AYA Site Recode 2020 Revision. Cases were also categorized into three groups: those treated at core hospitals for pediatric cancer treatment (pediatric cancer hospitals [PCHs]), those treated at designated cancer care hospitals, and those treated at nondesignated hospitals. The age-standardized incidence rate was 166.6 (per million-person years) for children (age 0-14 years) and 579.0 for AYAs (age 15-39 years) (including all cancers and benign or uncertain-behavior central nervous system [CNS] tumors). The type of cancer varied with age: hematological malignancies, blastomas, and CNS tumors were common in children under 10 years, malignant bone tumors and soft tissue sarcomas were relatively common in teenagers, and in young adults over 20 years, carcinomas in thyroid, testis, gastrointestinal, female cervix, and breast were common. The proportion of cases treated at PCHs ranged from 20% to 30% for children, 10% or less for AYAs, and differed according to age group and cancer type. Based on this information, the optimal system of cancer care should be discussed.
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Affiliation(s)
- Kayo Nakata
- Cancer Control CenterOsaka International Cancer InstituteOsakaJapan
- National Cancer Center Institute for Cancer ControlTokyoJapan
| | | | - Megumi Hori
- Department of NursingUniversity of ShizuokaShizuokaJapan
| | - Hiromi Sugiyama
- Department of EpidemiologyRadiation Effects Research FoundationHiroshimaJapan
| | - Ken Tabuchi
- Tokyo Cancer Registry, Bureau of Social Welfare and Public HealthTokyo Metropolitan GovernmentTokyoJapan
| | - Isao Miyashiro
- Cancer Control CenterOsaka International Cancer InstituteOsakaJapan
| | - Kimikazu Matsumoto
- Children's Cancer CenterNational Center for Child Health and DevelopmentTokyoJapan
| | - Akihiro Yoneda
- Division of Surgery, Surgical OncologyNational Center for Child Health and DevelopmentTokyoJapan
- Division of Pediatric Surgical OncologyNational Cancer Center HospitalTokyoJapan
| | - Junko Takita
- Department of Pediatrics, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Chikako Shimizu
- Department of Breast and Medical OncologyNational Center for Global Health and MedicineTokyoJapan
| | - Kota Katanoda
- National Cancer Center Institute for Cancer ControlTokyoJapan
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Botta L, Gatta G, Capocaccia R, Stiller C, Cañete A, Dal Maso L, Innos K, Mihor A, Erdmann F, Spix C, Lacour B, Marcos-Gragera R, Murray D, Rossi S, Hackl M, Van Eycken E, Van Damme N, Valerianova Z, Sekerija M, Scoutellas V, Demetriou A, Dušek L, Krejci D, Storm H, Mägi M, Innos K, Paapsi K, Malila N, Pitkäniemi J, Jooste V, Clavel J, Poulalhon C, Lacour B, Desandes E, Monnereau A, Erdmann F, Spix C, Katalinic A, Petridou E, Markozannes G, Garami M, Birgisson H, Murray D, Walsh PM, Mazzoleni G, Vittadello F, Cuccaro F, Galasso R, Sampietro G, Rosso S, Gasparotto C, Maifredi G, Ferrante M, Torrisi A, Sutera Sardo A, Gambino ML, Lanzoni M, Ballotari P, Giacomazzi E, Ferretti S, Caldarella A, Manneschi G, Gatta G, Sant M, Baili P, Berrino F, Botta L, Trama A, Lillini R, Bernasconi A, Bonfarnuzzo S, Vener C, Didonè F, Lasalvia P, Del Monego G, Buratti L, Serraino D, Taborelli M, Capocaccia R, De Angelis R, Demuru E, Di Benedetto C, Rossi S, Santaquilani M, Venanzi S, Tallon M, Boni L, Iacovacci S, Russo AG, Gervasi F, Spagnoli G, Cavalieri d'Oro L, Fusco M, Vitale MF, Usala M, Vitale F, Michiara M, Chiranda G, Sacerdote C, Maule M, Cascone G, Spata E, Mangone L, Falcini F, Cavallo R, Piras D, Dinaro Y, Castaing M, Fanetti AC, Minerba S, Candela G, Scuderi T, Rizzello RV, Stracci F, Tagliabue G, Rugge M, Brustolin A, Pildava S, Smailyte G, Azzopardi M, Johannesen TB, Didkowska J, Wojciechowska U, Bielska-Lasota M, Pais A, Ferreira AM, Bento MJ, Miranda A, Safaei Diba C, Zadnik V, Zagar T, Sánchez-Contador Escudero C, Franch Sureda P, Lopez de Munain A, De-La-Cruz M, Rojas MD, Aleman A, Vizcaino A, Almela F, Marcos-Gragera R, Sanvisens A, Sanchez MJ, Chirlaque MD, Sanchez-Gil A, Guevara M, Ardanaz E, Cañete-Nieto A, Peris-Bonet R, Galceran J, Carulla M, Kuehni C, Redmond S, Visser O, Karim-Kos H, Stevens S, Stiller C, Gavin A, Morrison D, Huws DW. Long-term survival and cure fraction estimates for childhood cancer in Europe (EUROCARE-6): results from a population-based study. Lancet Oncol 2022; 23:1525-1536. [DOI: 10.1016/s1470-2045(22)00637-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/17/2022]
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Kelly SM, Effeney R, Gaze MN, Bernier-Chastagner V, Blondeel A, Clementel E, Corning C, Dieckmann K, Essiaf S, Gandola L, Janssens GO, Kearns PR, Lacombe D, Lassen-Ramshad Y, Merks H, Miles E, Padovani L, Scarzello G, Schwarz R, Timmermann B, van Rijn RR, Vassal G, Boterberg T, Mandeville HC. QUARTET: A SIOP Europe project for quality and excellence in radiotherapy and imaging for children and adolescents with cancer. Eur J Cancer 2022; 172:209-220. [PMID: 35780527 DOI: 10.1016/j.ejca.2022.05.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 12/21/2022]
Abstract
The European Society for Paediatric Oncology (SIOPE) Radiation Oncology Working Group presents the QUARTET Project: a centralised quality assurance programme designed to standardise care and improve the quality of radiotherapy and imaging for international clinical trials recruiting children and adolescents with cancer throughout Europe. QUARTET combines the paediatric radiation oncology expertise of SIOPE with the infrastructure and experience of the European Organisation for Research and Treatment of Cancer to deliver radiotherapy quality assurance programmes for large, prospective, international clinical trials. QUARTET-affiliated trials include children and adolescents with brain tumours, neuroblastoma, sarcomas including rhabdomyosarcoma, and renal tumours including Wilms' tumour. With nine prospective clinical trials and two retrospective studies within the active portfolio in March 2022, QUARTET will collect one of the largest repositories of paediatric radiotherapy and imaging data, support the clinical assessment of radiotherapy, and evaluate the role and benefit of radiotherapy quality assurance for this cohort of patients within the context of clinical trials.
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Affiliation(s)
- Sarah M Kelly
- European Society for Paediatric Oncology (SIOPE), Clos Chapelle-aux-Champs 30, Brussels, Belgium; The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue E. Mounier 83, Brussels, Belgium; Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Rachel Effeney
- European Society for Paediatric Oncology (SIOPE), Clos Chapelle-aux-Champs 30, Brussels, Belgium; The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue E. Mounier 83, Brussels, Belgium
| | - Mark N Gaze
- Department of Oncology, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London, NW1 2PG, United Kingdom
| | | | - Anne Blondeel
- European Society for Paediatric Oncology (SIOPE), Clos Chapelle-aux-Champs 30, Brussels, Belgium
| | - Enrico Clementel
- The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue E. Mounier 83, Brussels, Belgium
| | - Coreen Corning
- The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue E. Mounier 83, Brussels, Belgium
| | - Karin Dieckmann
- Children's Cancer Research Institute, St Anna Kinderkrebsforschung, Medical University of Vienna, Vienna, Austria; Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Samira Essiaf
- European Society for Paediatric Oncology (SIOPE), Clos Chapelle-aux-Champs 30, Brussels, Belgium
| | - Lorenza Gandola
- Department of Radiation Oncology, Fondazione IRCCS-Istituto Nazionale Dei Tumori, Milan, Italy
| | - Geert O Janssens
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands; Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Pamela R Kearns
- European Society for Paediatric Oncology (SIOPE), Clos Chapelle-aux-Champs 30, Brussels, Belgium; Cancer Research UK Clinical Trials Unit, National Institute for Health Research Birmingham Biomedical Research Centre, Institute of Cancer and Genomic Services, University of Birmingham, United Kingdom
| | - Denis Lacombe
- The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Avenue E. Mounier 83, Brussels, Belgium
| | | | - Hans Merks
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Elizabeth Miles
- National Radiotherapy Trials Quality Assurance (RTTQA) Group, Mount Vernon Cancer Centre, United Kingdom
| | - Laetitia Padovani
- Department of Radiation Oncology, Assistance Publique Hôpitaux de Marseille, France
| | - Giovanni Scarzello
- Radiation Therapy Department, Veneto Institute of Oncology IRCCS, Padua, Italy
| | - Rudolf Schwarz
- Department of Radiation Oncology, Medical Center Hamburg-Eppendorf, Hamburg, Martinistr. 52, D 20246 Hamburg Germany
| | - Beate Timmermann
- Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Centre Essen (WPE), West German Cancer Center (WTZ), Germany; German Consortium for Translational Cancer Research (DKTK), Essen, Germany
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital - Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Gilles Vassal
- European Society for Paediatric Oncology (SIOPE), Clos Chapelle-aux-Champs 30, Brussels, Belgium; Department of Pediatric Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Tom Boterberg
- Department of Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Henry C Mandeville
- Department of Radiotherapy, The Royal Marsden Hospital and the Institute of Cancer Research, Sutton, United Kingdom
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de Ville de Goyet J, Illhardt T, Chardot C, Dike PN, Baumann U, Brandt K, Wildhaber BE, Pakarinen M, di Francesco F, Sturm E, Cornet M, Lemoine C, Pfister ED, Calinescu AM, Hukkinen M, Harpavat S, Tuzzolino F, Superina R. Variability of Care and Access to Transplantation for Children with Biliary Atresia Who Need a Liver Replacement. J Clin Med 2022; 11. [PMID: 35456234 DOI: 10.3390/jcm11082142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/24/2022] [Accepted: 03/09/2022] [Indexed: 02/04/2023] Open
Abstract
Background & Aims: Biliary atresia (BA) is the commonest single etiology indication for liver replacement in children. As timely access to liver transplantation (LT) remains challenging for small BA children (with prolonged waiting time being associated with clinical deterioration leading to both preventable pre- and post-transplant morbidity and mortality), the care pathway of BA children in need of LT was analyzed—from diagnosis to LT—with particular attention to referral patterns, timing of referral, waiting list dynamics and need for medical assistance before LT. Methods: International multicentric retrospective study. Intent-to-transplant study analyzing BA children who had indication for LT early in life (aged < 3 years at the time of assessment), over the last 5 years (2016−2020). Clinical and laboratory data of 219 BA children were collected from 8 transplant centers (6 in Europe and 2 in USA). Results: 39 patients underwent primary transplants. Children who underwent Kasai in a specialist -but not transplant- center were older at time of referral and at transplant. At assessment for LT, the vast majority of children already were experiencing complication of cirrhosis, and the majority of children needed medical assistance (nutritional support, hospitalization, transfusion of albumin or blood) while waiting for transplantation. Severe worsening of the clinical condition led to the need for requesting a priority status (i.e., Peld Score exception or similar) for timely graft allocation for 76 children, overall (35%). Conclusions: As LT currently results in BA patient survival exceeding 95% in many expert LT centers, the paradigm for BA management optimization and survival have currently shifted to the pre-LT management. The creation of networks dedicated to the timely referral to a pediatric transplant center and possibly centralization of care should be considered, in combination with implementing all different graft type surgeries in specialist centers (including split and living donor LTs) to achieve timely LT in this vulnerable population.
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Nakata K, Williams R, Kinoshita Y, Koshinaga T, Moroz V, Al-Saadi R, Vujanic G, Oue T, Pritchard-Jones K. Comparative analysis of the clinical characteristics and outcomes of patients with Wilms tumor in the United Kingdom and Japan. Pediatr Blood Cancer 2021; 68:e29143. [PMID: 34056846 DOI: 10.1002/pbc.29143] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/28/2021] [Accepted: 05/07/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Wilms tumor (WT) demonstrates epidemiological differences by world region and ethnicity. To enhance understanding of these differences, we retrospectively analyzed clinical trial data sets from the UK and Japan over a 20-year period. PROCEDURE We used data from three consecutive clinical trials in the UK and a single study in Japan that enrolled patients diagnosed during 1996-2015, to compare clinical characteristics and outcomes between countries. RESULTS During 1996-2015, 1395 patients in the UK and 537 in Japan were included. Japanese patients have a significantly younger median age at diagnosis than those in the UK (28 months vs 39 months). The proportion of patients with stage IV, large tumors, and anaplastic histology appears to be higher in the UK than in Japan (18% vs 11%, 62% vs 49%, 8% vs 3%, respectively). During 2005-2015, 77 hospitals treated WT in Japan compared with only 20 hospitals in the UK. Five-year overall survival of patients with WT was over 90% in both countries, but five-year event-free survival of patients with stage IV was significantly lower in Japan than in the UK (50.0% vs 76.2%, P = 0.001). CONCLUSIONS Differences in age of onset, tumor size at diagnosis, and histology may reflect differences in the genetic background of patients with WT between countries, but population-based phenotype-genotype data are lacking. The difference in survival probability for stage IV patients may be due to different diagnostic criteria or different treatment strategies. Prospective, international clinical studies including genomic analyses are needed to confirm these findings and improve clinical practice.
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Affiliation(s)
- Kayo Nakata
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Richard Williams
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Imperial BRC Genomics Facility, Imperial College London, London, UK
| | - Yoshiaki Kinoshita
- Malignant Tumor Committee, Japanese Society of Pediatric Surgeons, Tokyo, Japan
| | | | - Veronica Moroz
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Reem Al-Saadi
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | | | - Takaharu Oue
- Department of Pediatric Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Kathy Pritchard-Jones
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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Groenendijk A, Spreafico F, de Krijger RR, Drost J, Brok J, Perotti D, van Tinteren H, Venkatramani R, Godziński J, Rübe C, Geller JI, Graf N, van den Heuvel-Eibrink MM, Mavinkurve-Groothuis AMC. Prognostic Factors for Wilms Tumor Recurrence: A Review of the Literature. Cancers (Basel) 2021; 13:cancers13133142. [PMID: 34201787 PMCID: PMC8268923 DOI: 10.3390/cancers13133142] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/08/2021] [Accepted: 06/18/2021] [Indexed: 01/10/2023] Open
Abstract
Simple Summary A Wilms tumor is a childhood kidney tumor. In high-income countries, 90% of patients with this tumor survive. However, the tumor recurs in 15% of patients. It is important to identify the patients at risk of recurrence in order to adjust treatment in such a way that recurrence may potentially be prevented. However, we are currently unable to determine precisely which patients are at risk of recurrence. Therefore, we present an overview of factors that influence the risk of recurrence, also known as prognostic factors. These factors range from patient-, tumor- and treatment-related characteristics to geographic and socioeconomic factors. In addition to these factors, biological markers, such as genetic alterations, should be studied more intensively as these markers may be able to better identify patients at risk of tumor recurrence. Abstract In high-income countries, the overall survival of children with Wilms tumors (WT) is ~90%. However, overall, 15% of patients experience tumor recurrence. The adverse prognostic factors currently used for risk stratification (advanced stage, high risk histology, and combined loss of heterozygosity at 1p and 16q in chemotherapy-naïve WTs) are present in only one third of these cases, and the significance of these factors is prone to change with advancing knowledge and improved treatment regimens. Therefore, we present a comprehensive, updated overview of the published prognostic variables for WT recurrence, ranging from patient-, tumor- and treatment-related characteristics to geographic and socioeconomic factors. Improved first-line treatment regimens based on clinicopathological characteristics and advancing knowledge on copy number variations unveil the importance of further investigating the significance of biological markers for WT recurrence in international collaborations.
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Affiliation(s)
- Alissa Groenendijk
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
- Correspondence:
| | - Filippo Spreafico
- Department of Medical Oncology and Hematology, Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Ronald R. de Krijger
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
- Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Jarno Drost
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
- Oncode Institute, 3584 CS Utrecht, The Netherlands
| | - Jesper Brok
- Department of Pediatric Oncology and Hematology, Rigshospitalet, 2100 Copenhagen, Denmark;
- Developmental Biology and Cancer Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Daniela Perotti
- Molecular Bases of Genetic Risk and Genetic Testing Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Harm van Tinteren
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
| | | | - Jan Godziński
- Department of Pediatric Surgery, Marciniak Hospital, Fieldorfa 2, 54-049 Wroclaw, Poland;
- Department of Pediatric Traumatology and Emergency Medicine, Wroclaw Medical University, Bujwida 44a, 50-345 Wroclaw, Poland
| | - Christian Rübe
- Department of Radiation Oncology, Saarland University Medical Center and Saarland University Faculty of Medicine, D-66421 Homburg, Germany;
| | - James I. Geller
- Division of Oncology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA;
| | - Norbert Graf
- Department of Pediatric Oncology and Hematology, Saarland University Medical Center and Saarland University Faculty of Medicine, D-66421 Homburg, Germany;
| | - Marry M. van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
| | - Annelies M. C. Mavinkurve-Groothuis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
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Shamash J, Ansell W, Alifrangis C, Thomas B, Wilson P, Stoneham S, Mazhar D, Warren A, Barrett T, Alexander S, Rudman S, Lockley M, Berney D, Sahdev A. The impact of a supranetwork multidisciplinary team (SMDT) on decision-making in testicular cancers: a 10-year overview of the Anglian Germ Cell Cancer Collaborative Group (AGCCCG). Br J Cancer 2021; 124:368-374. [PMID: 32989229 PMCID: PMC7853071 DOI: 10.1038/s41416-020-01075-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 07/25/2020] [Accepted: 08/17/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The germ cell supranetwork multidisciplinary team (SMDT) for the Anglian Network covers a population of 7.5 million. METHODS We reviewed 10 years of SMDT discussion and categorised them into five domains ((1) overall outcome, (2) chemotherapy regimens-untreated disease and salvage therapy, (3) radiology, (4) pathology and (5) complex cases) to assess the impact of the SMDT. RESULTS A total of 2892 new cases were reviewed. In the first 5 years, patients with good prognosis disease had poorer survival in low-volume vs high-volume centres (87.8 vs 95.3, p = 0.02), but the difference was no longer significant in the last 5 years (93.3 vs 95.1, p = 0.30). Radiology review of 3206 scans led to rejection of the diagnosis of progression in 26 cases and a further 10 cases were down-staged. There were 790 pathology reviews by two specialised uropathologists, which lead to changes in 75 cases. 18F-fluorodeoxyglucose (18FDG) PET-CT was undertaken during this time period but did not help to predict who would have viable cancer. A total of 26 patients with significant mental health issues who were unable to give informed consent were discussed. CONCLUSION SMDT working has led to an improvement in outcomes and refining of treatment in patients with germ cell tumours.
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Affiliation(s)
| | | | | | - Benjamin Thomas
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | | | - Danish Mazhar
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Anne Warren
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Tristan Barrett
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Susanna Alexander
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Sarah Rudman
- Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Michelle Lockley
- Centre for Cancer Cell and Molecular Biology, Barts Cancer Institute, Queen Mary University of London, London, UK
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Moreno F, Rose A, Chaplin MA, Cipolla MC, García Lombardi M, Nana M, Cervio G, Halac E, Viso M, Ayarzabal V, Bosaleh A, Liberto D, Sarabia E, Rizzi A, Morici M, Streitenberger P, de Dávila MTG. Childhood liver tumors in Argentina: Incidence trend and survival by treatment center. A report from the national pediatric cancer registry, ROHA network 2000-2015. Pediatr Blood Cancer 2020; 67:e28583. [PMID: 32737960 DOI: 10.1002/pbc.28583] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 06/19/2020] [Accepted: 06/29/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Information on the epidemiology of pediatric liver tumors in Latin America is limited. PURPOSE To describe the incidence of liver tumors in a pediatric registry in Argentina according to geographic region, national trends over 16 years, and survival related to stage, age, sex, and care center. METHODS Newly diagnosed liver tumors cases are registered in the Argentine Pediatric Oncology Hospital Registry (ROHA) with an estimated coverage of 91% of national cases. Age-standardized incidence rate per millon (ASR) was calculated based on the National Vital Statistics Reports. Five-year overall survival (OS) was estimated using the Kaplan-Meier method. The log-rank test was used to compare subgroup survival. RESULTS Two hundred seven cases of hepatoblastoma (HB) and 73 of hepatocellular carcinoma (HCC) were identified. ASR of liver tumors was 1.8/million (95% confidence Interval [CI], 1.6-2.0) per year. ASR was 1.4 (1.2-1.6) for HB and 0.4 (0.3-0.5) for HCC. For HB, the highest incidence was found in the northwest region including the Altiplano. OS was 60.4% (53.4-66.8) for HB and 36.1% (25.2-47.2) for HCC. Five-year survival rate of children with metastatic HB treated at liver transplant hospitals (LTH) was 54.2% (30.3-73.0) compared to 13.3% (2.2-34.6) for those seen at other hospitals (OH) (P = .02), while for HCC this rate was 46.3% (30.7-60.6) at LTH compared to 17.5% (3.1-41.9) at OH (P = .01). CONCLUSIONS The incidence rate of pediatric liver tumors was stable over the 16-year study period. Patients may benefit if at treatment initiation they are evaluated jointly with LTH specialists to define treatment strategies.
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Affiliation(s)
- Florencia Moreno
- Argentinian Pediatric Oncology Registry, Ministry of Health, National Cancer Institute, Buenos Aires, Argentina
| | - Adriana Rose
- Garrahan Pediatric Hospital, Buenos Aires, Argentina
| | - M Agustina Chaplin
- Argentinian Pediatric Oncology Registry, Ministry of Health, National Cancer Institute, Buenos Aires, Argentina
| | - M Cristina Cipolla
- Nacional Department of Maternity, Childhood, and Adolescence, Ministry of Health, Buenos Aires, Argentina
| | | | - Mariana Nana
- Ricardo Gutiérrez Children's Hospital, Buenos Aires, Argentina
| | | | - Esteban Halac
- Garrahan Pediatric Hospital, Buenos Aires, Argentina
| | | | | | | | | | - Elena Sarabia
- Dr Humberto J. Notti Children's Hospital, Mendoza, Argentina
| | - Ana Rizzi
- Garrahan Pediatric Hospital, Buenos Aires, Argentina
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Lauten M, Kontny U, Nathrath M, Schrappe M. [DKG certification of paediatric cancer centres - a wide field …]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:475-481. [PMID: 32161982 PMCID: PMC7578139 DOI: 10.1007/s00103-020-03112-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Die Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH) und die Deutsche Krebsgesellschaft (DKG) haben Kriterien für die DKG-Zertifizierung der Kinderonkologie erarbeitet, nach denen 2017 in Deutschland erstmals pädiatrisch-onkologische Abteilungen zertifiziert wurden. Das Ziel der DKG-Zertifizierung ist „die Vereinheitlichung und die transparente Darstellung der Versorgungsqualität für pädiatrische Patientinnen und Patienten mit hämato-onkologischen Erkrankungen“, wie 2018 in einer Veröffentlichung von Mensah et al. dargestellt. Die Auswahl der Zertifizierungskriterien hat innerhalb der GPOH zu einer intensiven Diskussion darüber geführt, inwieweit die Kriterien für sich genommen einer wissenschaftlichen Überprüfbarkeit standhalten und damit valide Parameter für die Bestimmung der Versorgungsqualität in der Kinderonkologie in Deutschland darstellen. Wir haben untersucht, ob aus der Arbeit von Mensah et al. valide Folgerungen für das deutsche Gesundheitssystem ableitbar sind. Dabei zeigt sich, dass die momentan definierten DKG-Zertifizierungskriterien für die Kinderonkologie in Deutschland in kritischen Bereichen einer fundierten wissenschaftlichen Grundlage entbehren. Diese Arbeit stellt Fallzahlen als Maß für Qualität in der Kinderonkologie infrage und regt die Entwicklung alternativer Kriterien für die Überprüfbarkeit von Qualität in der deutschen Kinderonkologie an.
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Affiliation(s)
- Melchior Lauten
- Klinik für Kinder- und Jugendmedizin, Bereich Kinderhämatologie und Onkologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
| | - Udo Kontny
- Klinik für Kinder- und Jugendmedizin, Sektion Pädiatrische Hämatologie, Onkologie und Stammzelltransplantation, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - Michaela Nathrath
- Pädiatrische Hämatologie und Onkologie, Psychosomatik und Systemerkrankungen, Klinikum Kassel, Kassel, Deutschland
| | - Martin Schrappe
- Klinik für Kinder- und Jugendmedizin I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
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