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Sathitsamitphong L, Chitapanarux I, Srikummoon P, Thongsak N, Nakharutai N, Thumronglaohapun S, Supasri T, Hemwan P, Traisathit P. Ambient air pollution as a time-varying covariate in the survival probability of childhood cancer patients in the upper Northern Thailand. PLoS One 2024; 19:e0303182. [PMID: 38728338 PMCID: PMC11086912 DOI: 10.1371/journal.pone.0303182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/20/2024] [Indexed: 05/12/2024] Open
Abstract
The objective of this study is to determine the possible association between exposure to air pollution and the risk of death from cancer during childhood in upper northern Thailand. Data were collected on children aged 0-15 years old diagnosed with cancer between January 2003 and December 2018 from the Chiang Mai Cancer Registry. Survival rates were determined by using Kaplan-Meier curves. Cox proportional hazard models were used to investigate associations of potential risk factors with the time-varying air pollution level on the risk of death. Of the 540 children with hematologic cancer, 199 died from any cause (overall mortality rate = 5.3 per 100 Person-Years of Follow-Up (PYFU); 95%CI = 4.6-6.0). Those aged less than one year old (adjusted hazard ratio [aHR] = 2.07; 95%CI = 1.25-3.45) or ten years old or more (aHR = 1.41; 95%CI = 1.04-1.91) at the time of diagnosis had a higher risk of death than those aged one to ten years old. Those diagnosed between 2003 and 2013 had an increased risk of death (aHR = 1.65; 95%CI = 1.13-2.42). Of the 499 children with solid tumors, 214 died from any cause (5.9 per 100 PYFU; 95%CI = 5.1-6.7). Only the cancer stage remained in the final model, with the metastatic cancer stage (HR = 2.26; 95%CI = 1.60-3.21) and the regional cancer stage (HR = 1.53; 95%CI = 1.07-2.19) both associated with an increased risk of death. No association was found between air pollution exposure and all-cause mortality for either type of cancer. A larger-scale analytical study might uncover such relationships.
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Affiliation(s)
| | - Imjai Chitapanarux
- Northern Thai Research Group of Therapeutic Radiology and Oncology (NTRG-TRO), Divisions of Radiation Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pimwarat Srikummoon
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Natthapat Thongsak
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Nawapon Nakharutai
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | | | - Titaporn Supasri
- Atmospheric Research Unit of National Astronomical Research Institute of Thailand, Chiang Mai, Thailand
| | - Phonpat Hemwan
- Geo-Informatics and Space Technology Centre (Northern Region), Department of Geography, Faculty of Social Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Patrinee Traisathit
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
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Nissen TN, Rechnitzer C, Albertsen BK, Borgwardt L, Christensen VB, Fallentin E, Hasle H, Johansen LS, Maroun LL, Nissen KB, Rasmussen A, Rathe M, Rosthøj S, Schultz NA, Wehner PS, Jørgensen MH, Brok J. Epidemiological Study of Malignant Paediatric Liver Tumours in Denmark 1985-2020. Cancers (Basel) 2023; 15:3355. [PMID: 37444465 DOI: 10.3390/cancers15133355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Malignant liver tumours in children are rare and national outcomes for this tumour entity are rarely published. This study mapped paediatric liver tumours in Denmark over 35 years and reported on the incidence, outcomes and long-term adverse events. METHODS We identified all liver tumours from the Danish Childhood Cancer Registry and reviewed the case records for patient and tumour characteristics, treatment and clinical outcome. RESULTS We included 79 patients in the analyses. Overall crude incidence was ~2.29 per 1 million children (<15 yr) per year, with 61 hepatoblastomas (HB), 9 hepatocellular carcinomas and 9 other hepatic tumours. Overall 5-year survival was 84%, 78% and 44%, respectively. Nine patients had underlying liver disease or predisposition syndrome. Seventeen children underwent liver transplantation, with two late complications, biliary stenosis and liver fibrosis. For HB, age ≥ 8 years and diagnosis prior to 2000 were significant predictors of a poorer outcome. Adverse events included reduced renal function in 10%, reduced cardiac function in 6% and impaired hearing function in 60% (19% needed hearing aids). Behavioural conditions requiring additional support in school were registered in 10 children. CONCLUSIONS In Denmark, incidences of malignant liver tumours during the last four decades have been increasing, as reported in the literature. HB survival has improved since the year 2000 and is comparable with international results. Reduced hearing is the major treatment-related side effect and affects approximately 60% of patients.
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Affiliation(s)
- Thomas N Nissen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Catherine Rechnitzer
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Birgitte K Albertsen
- Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, 8200 Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, 8200 Aarhus, Denmark
| | - Lotte Borgwardt
- Department of Radiology, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Vibeke B Christensen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Eva Fallentin
- Department of Radiology, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Henrik Hasle
- Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Lars S Johansen
- Department of Paediatric Surgery, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Lisa L Maroun
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Karin B Nissen
- Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Allan Rasmussen
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Mathias Rathe
- Department of Paediatric Haematology and Oncology, H. C. Andersen Children's Hospital, Odense University Hospital, 5000 Odense, Denmark
| | - Steen Rosthøj
- Department of Paediatrics and Adolescent Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Nicolai A Schultz
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Peder S Wehner
- Department of Paediatric Haematology and Oncology, H. C. Andersen Children's Hospital, Odense University Hospital, 5000 Odense, Denmark
| | - Marianne H Jørgensen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Jesper Brok
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
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Parametric Models for Survival Analysis of Childhood Cancer Patients' Data. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2022. [DOI: 10.5812/ijcm-127430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The rate of childhood cancer death has dropped steadily over the past 50 years. The pediatric cancer risk has remained under investigation. Objectives: This study aims at investigating the associated factors with the survival of pediatric patients with retinoblastoma, sarcoma, brain tumor, and leukemia cancer. Methods: The cohort study of 1879 children with retinoblastoma, sarcoma, brain tumor, and leukemia aged < 1, 1 - 5, 6 - 10, 11 - 15, and > 15 years in Mahak Hospital and Rehabilitation Complex from 2007 to 2016 were enrolled in the study. Median survival time was reported for each cancer. Parametric survival models including Gompertz, Weibull, lognormal, and log‑logistic models were fitted. Then, the model with almost minimum Akaike information criterion (AIC) was chosen. The hazard ratio (HR) and the analysis were performed by R3.5.1. Results: Totally, 270 (14.37%) patients with Retinoblastoma, 667 (35.5%) with leukemia, 625 (33.26%) with a Brain tumor, and 317 (16.87%) with Sarcoma were included in this study; 815 (43.37%) patients were female. Gompertz's model was chosen to fit the data due to the minimum AIC. The associated factors with the survival of childhood cancers were as follows: age < 1 year, parental relation, loco-regional relapse and chemotherapy alone (HR: 7.63, 1.56, 4.61, 1.12) in leukemia, other nationalities, metastasis or metastasis and loco-regional relapse and chemotherapy alone (HR = 3.74, 5.75, 2.12) in retinoblastoma, loco-regional relapse and metastasis (HR = 2.40, 3.71) in brain tumor, other ages except for 5 - 10 years, parental relation, chemotherapy alone, and metastasis (HR = 33.3, 1.80, 3.57, 3.8) in sarcoma. Conclusions: Age, parental familial relationships, combination therapy, and metastasis of primary cancer were the risk factors for survival of children with 4 common cancers of leukemia, retinoblastoma, brain tumors, and sarcoma, using the Gompertz model.
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Kohler BE, Sandler CX, Baque E, Bradford NK, Trost SG. Therapeutic exercise interventions in pediatric survivors of brain cancer and other solid tumors: A scoping review. Front Pediatr 2022; 10:979292. [PMID: 36210932 PMCID: PMC9535626 DOI: 10.3389/fped.2022.979292] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/25/2022] [Indexed: 11/19/2022] Open
Abstract
Background Improved survival rates for children with solid tumors presents an ongoing challenge of how to maximize quality of survivorship and effectively manage the short- and long-term complications of disease and treatment. To gain an understanding of the extent and nature of research pertaining to therapeutic exercise interventions and identify knowledge gaps, we conducted a scoping review of exercise training studies conducted in pediatric survivors of brain cancer and other solid tumors. Method A systematic literature search was performed across four electronic databases. Papers were selected for full-text review if they included participants treated for brain cancer or other solid tumors, with at least 50% of participants aged ≤ 21 years, evaluated an exercise intervention ≥2-weeks in duration, and were published in an English, peer-reviewed journal. We included the following quantitative study designs; randomized controlled trials, non-randomized trials, and single-arm pre-test-post-test. Results Of the 7,482 citations identified, 17 papers met the inclusion criteria (presenting findings from eleven studies). Two studies were randomized controlled trials, five studies were non-randomized controlled trials, and four studies were a single-arm pre-test post-test design. Average age of participants ranged from 7.3-15.5 years, and time since diagnosis ranged from 3 to 70 months. Five studies included participants with brain tumors exclusively, three studies included other solid tumors, and three studies included a mixed sample (brain and other solid tumors). A wide range of exercise modalities were employed, including cycle ergometry, resistance training, sport, yoga, and active gaming. The length of the exercise program ranged from 3-40 weeks and frequency from 3-11 sessions per week. Exercise session duration ranged from 15-180 min, with most studies reporting 30-90-min sessions. Adherence ranged from 77 to 100%, with none of the studies reporting adverse events. Studies reported improvements in cardiorespiratory fitness, functional strength, physical activity, and quality of life. Conclusions A small number of mostly low methodological quality studies have examined the effects of therapeutic exercise in pediatric survivors of solid tumors. Although limited, the extant literature supports the feasibility and safety of therapeutic exercise interventions for pediatric survivors of brain cancer and other solid tumors.
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Affiliation(s)
- Brooke E. Kohler
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Carolina X. Sandler
- Sport and Exercise Science, School of Health Sciences, Western Sydney University, Sydney, NSW, Australia
- UNSW Fatigue Research Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Emmah Baque
- School of Health Sciences and Social Work, Griffith University, Nathan, QLD, Australia
| | - Natalie K. Bradford
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Cancer and Palliative Care Outcomes Centre, at Centre for Children's Health Research, Queensland University of Technology, South Brisbane, QLD, Australia
| | - Stewart G. Trost
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
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Wong ES, Choy RW, Zhang Y, Chu WK, Chen LJ, Pang CP, Yam JC. Global retinoblastoma survival and globe preservation: a systematic review and meta-analysis of associations with socioeconomic and health-care factors. THE LANCET GLOBAL HEALTH 2022; 10:e380-e389. [DOI: 10.1016/s2214-109x(21)00555-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 12/17/2022] Open
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Evers M, Rechnitzer C, Graem N, Skov Wehner P, Schroeder H, Rosthoej S, Mosbech CH, Hoei-Hansen CE, Sehested A, Treger TD, Brok J. Epidemiological study of paediatric germ cell tumours revealed the incidence and distribution that was expected, but a low mortality rate. Acta Paediatr 2017; 106:779-785. [PMID: 28135773 DOI: 10.1111/apa.13767] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/03/2016] [Accepted: 01/25/2017] [Indexed: 12/31/2022]
Abstract
AIM Germ cell tumours (GCTs) are a rare heterogeneous tumour group derived from primordial germ cells, which can be benign or malignant and occur in the gonads or extragonadally. This study mapped the paediatric GCTs in Denmark from 1984 to 2013 to study the incidence and outcome. METHODS We identified paediatric GCTs from the Danish Childhood Cancer and National Pathology Registries and reviewed the case records for patient characteristics, tumour characteristics and clinical outcome. RESULTS We identified 403 (71% female) paediatric GCTs and the crude incidence was 1.43 per 100 000. Of these, 79 (20%) were malignant, 39 (10%) were potentially malignant and 285 (70%) were benign. Extragonadal GCTs (39%) were mainly observed in early childhood and were predominately sacrococcygeal teratomas. Gonadal GCTs (61%) in late childhood were most frequently mature teratomas in the ovaries. Nearly all patients underwent surgery. Of the malignant tumours, 62% were treated with chemotherapy. Radiotherapy was only administered to intracranial GCTs. In the cohort, 12 patients died (3%). CONCLUSION Paediatric GCTs in Denmark were mainly benign and mortality was low, even for malignant tumours. We identified a peak of extragonadal GCTs in early childhood and a peak of gonadal GCTs in late childhood, which was comparable to previous reports.
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Affiliation(s)
- Madeline Evers
- Department of Paediatric and Adolescent Haematology and Oncology; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Catherine Rechnitzer
- Department of Paediatric and Adolescent Haematology and Oncology; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Niels Graem
- Department of Pathology; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Peder Skov Wehner
- Department of Paediatric Haematology and Oncology; H. C. Andersen Children's Hospital; Odense University Hospital; Odense Denmark
| | - Henrik Schroeder
- Department of Paediatric Oncology; Aarhus University Hospital; Aarhus Denmark
| | - Steen Rosthoej
- Paediatric Oncology Section; Paediatric Department; Aalborg University Hospital; Aalborg Denmark
| | | | | | - Astrid Sehested
- Department of Paediatric and Adolescent Haematology and Oncology; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Taryn D. Treger
- Cancer Section; Institute of Child Health; University College London; London UK
| | - Jesper Brok
- Department of Paediatric and Adolescent Haematology and Oncology; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
- Cancer Section; Institute of Child Health; University College London; London UK
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Lychou SE, Gustafsson GG, Ljungman GE. Higher rates of metastatic disease may explain the declining trend in Swedish paediatric rhabdomyosarcoma survival rates. Acta Paediatr 2016; 105:74-81. [PMID: 26331464 PMCID: PMC4738396 DOI: 10.1111/apa.13172] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 05/06/2015] [Accepted: 08/28/2015] [Indexed: 11/27/2022]
Abstract
AIM Positive outcomes for paediatric rhabdomyosarcoma (RMS) were high in Sweden during the 1990s, but the last decade has seen decreasing trends in overall survival rates. We investigated the incidence, patient and disease characteristics, treatment and outcome of RMS to see whether any reason could be found for this decline. METHODS This study included 210 children under the age of 15 who were diagnosed with RMS and whose details were recorded in the population-based Swedish Childhood Cancer Registry from 1984 to 2010. RESULTS The overall annual incidence of RMS was 4.9 per million, and the 5-year overall survival rates were 59 ± 7% in 1984-1989, 78 ± 5% in 1990-1999 and 71 ± 5% in 2000-2010. When patients with localised disease were analysed separately, there was no difference in the 5-year survival rates between 1990 and 1999 (82 ± 5%) and 2000-2010 (81 ± 5%), but the outcome in 1984-1989 (53 ± 8%) was significantly worse. The prevalence of metastatic disease was unexpectedly high during 2000-2010 (28%, p = 0.010), compared to an overall mean of 18% for the whole study period. CONCLUSION Our results suggest that a higher rate of metastatic disease may explain the declining trend in overall survival rates in paediatric RMS in Sweden over the last decade.
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Affiliation(s)
- Sara E. Lychou
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | | | - Gustaf E. Ljungman
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
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Pixberg C, Koch R, Eich HT, Martinsson U, Kristensen I, Matuschek C, Kortmann RD, Pohl F, Elsayad K, Christiansen H, Willich N, Lindh J, Steinmann D. Acute Toxicity Grade 3 and 4 After Irradiation in Children and Adolescents: Results From the IPPARCA Collaboration. Int J Radiat Oncol Biol Phys 2015; 94:792-9. [PMID: 26972652 DOI: 10.1016/j.ijrobp.2015.12.353] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 12/03/2015] [Accepted: 12/14/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE In the context of oncologic therapy for children, radiation therapy is frequently indicated. This study identified the frequency of and reasons for the development of high-grade acute toxicity and possible sequelae. MATERIALS AND METHODS Irradiated children have been prospectively documented since 2001 in the Registry for the Evaluation of Side Effects After Radiation in Childhood and Adolescence (RiSK) database in Germany and since 2008 in the registry for radiation therapy toxicity (RADTOX) in Sweden. Data were collected using standardized, published forms. Toxicity classification was based on Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. RESULTS As of June 2013, 1500 children have been recruited into the RiSK database and 485 into the RADTOX registry leading to an analysis population of 1359 patients (age range 0-18). A total of 18.9% (n=257) of all investigated patients developed high-grade acute toxicity (grades 3/4). High-grade toxicity of the bone marrow was documented for 63.8% (n=201) of those patients, oral mucositis for 7.6% (n=24), and dermatitis for 7.6% (n=24). Patients with high-grade acute toxicity received concomitant chemotherapy more frequently (56%) than patients with no or lower acute toxicity (31.5%). In multivariate analyses, concomitant chemotherapy, diagnosis of Ewing sarcoma, and total radiation dose showed a statistically noticeable effect (P≤.05) on acute toxicity, whereas age, concomitant chemotherapy, Hodgkin lymphoma, Ewing sarcoma, total radiation dose, and acute toxicity influenced the time until maximal late toxicity. CONCLUSIONS Generally, high-grade acute toxicity after irradiation in children and adolescence occurs in a moderate proportion of patients (18.9%). As anticipated, the probability of acute toxicity appeared to depend on the prescribed dose as well as concomitant chemotherapy. The occurrence of chronic toxicity correlates with the prior acute toxicity grade. Age seems to influence the time until maximal late toxicity but not the development of acute toxicity.
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Affiliation(s)
- Caroline Pixberg
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany
| | - Raphael Koch
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| | - Hans Theodor Eich
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany; Department of Radiation Oncology, University of Koeln, Koeln, Germany.
| | - Ulla Martinsson
- Department of Oncology, University Hospital, Uppsala, Sweden
| | - Ingrid Kristensen
- Department of Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Christiane Matuschek
- Department of Radiation Oncology, University Hospital of Duesseldorf, Duesseldorf, Germany
| | - Rolf-Dieter Kortmann
- Department of Radiation Oncology, University Hospital of Leipzig, Leipzig, Germany
| | - Fabian Pohl
- Department of Radiation Oncology, University of Regensburg, Regensburg, Germany
| | - Khaled Elsayad
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany
| | - Hans Christiansen
- Department of Radiation Oncology, Medical School Hannover, Hannover, Germany
| | - Normann Willich
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany
| | - Jack Lindh
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Diana Steinmann
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany; Department of Radiation Oncology, Medical School Hannover, Hannover, Germany
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Zaikova O, Sundby Hall K, Styring E, Eriksson M, Trovik CS, Bergh P, Bjerkehagen B, Skorpil M, Weedon-Fekjaer H, Bauer HCF. Referral patterns, treatment and outcome of high-grade malignant bone sarcoma in Scandinavia--SSG Central Register 25 years' experience. J Surg Oncol 2015; 112:853-60. [PMID: 26482729 DOI: 10.1002/jso.24074] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Accepted: 10/08/2015] [Indexed: 01/30/2023]
Abstract
AIMS The objectives of this study were to present changes in referral patterns, treatment and survival in patients with high-grade malignant bone sarcoma in Sweden and Norway based on data in the Scandinavian Sarcoma Group (SSG) Central Register. METHOD Data on 1,437 patients with diagnosis 1986-2010 was analyzed. RESULTS Osteosarcoma was the most frequentl diagnosis (45%), followed by Ewing sarcoma (21%) and chondrosarcoma (17%). Thirty-one percent of Swedish and 41% of Norwegian patients had tumors in the axial skeleton. Eighty-six percent of extremity tumors and 66% of axial tumors were referred to a sarcoma center prior to unplanned surgery or biopsy. During the past decade, limb salvage surgery has risen from under 50% to over 80%. Five-year overall survival in non-metastatic osteosarcoma was 70% for extremity tumors, and 35% for axial tumors. No improvement in osteosarcoma survival was observed during the last decade. Five-year survival in Ewing sarcoma improved from 50% to 69%. CONCLUSION Referral patterns in bone sarcomas have improved. However, greater efforts should be dedicated to improving referral of patients with possible tumors in the axial skeleton to multidisciplinary teams (MDTs). Overall survival of patients with high-grade malignant bone sarcomas in Sweden and Norway is in line with other reports.
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Affiliation(s)
- Olga Zaikova
- Department of Orthopedics, Oslo University Hospital, The Norwegian Radium Hospital, Norway
| | - Kirsten Sundby Hall
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Norway
| | - Emelie Styring
- Department of Orthopedics, Lund University and Skane University Hospital, Lund, Sweden
| | - Mikael Eriksson
- Department of Oncology, Skane University Hospital, and Lund University, Lund, Sweden
| | - Clement S Trovik
- Department of Orthopaedics, Haukeland University Hospital, Bergen, Norway
| | - Peter Bergh
- Department of Orthopaedics, Sahlgren University Hospital, Gothenburg, Sweden
| | - Bodil Bjerkehagen
- Department of Pathology, Oslo University Hospital, The Norwegian Radium Hospital, Norway
| | - Mikael Skorpil
- Department of Molecular Medicine and Surgery, Diagnostic Radiology, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Harald Weedon-Fekjaer
- Oslo Center for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Henrik C F Bauer
- Department of Molecular Medicine and Surgery, Section for Orthopaedics and Sports Medicine, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
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Punia RS, Mundi I, Kundu R, Jindal G, Dalal U, Mohan H. Spectrum of nonhematological pediatric tumors: A clinicopathologic study of 385 cases. Indian J Med Paediatr Oncol 2014; 35:170-4. [PMID: 25197181 PMCID: PMC4152636 DOI: 10.4103/0971-5851.138995] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: The aim of this study is to understand the epidemiology of tumors in children in our region due to a paucity of studies on the histologic review of the childhood tumors in general and benign tumors in particular. Materials and Methods: The records of all the tumors diagnosed histopathologically in children <14 years of age during a period of 8-year (2005-2012) were reviewed. Results: A total of 385 tumors were seen in the age range of 1 month-14 years with 231 (60%) in boys and 154 (40%) in girls. Highest number of cases, 224 (58.18%) were in the age group of 10-14 years. Benign tumors comprised 275 (71.43%) cases while the malignant tumors accounted for 110 (28.57%) cases. In benign tumors, vascular tumors were in majority with 68 cases, while in malignant category bone tumors were most common with 36 cases. Conclusions: Although the exact incidence rate cannot be provided by this hospital-based study, the information is useful in showing patterns of childhood tumors. We included both benign and malignant tumors, while most of the studies in the past have focused mainly on malignant tumors in children.
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Affiliation(s)
- Rajpal Singh Punia
- Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Irneet Mundi
- Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Reetu Kundu
- Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Geetanjali Jindal
- Department of Paediatrics, Government Medical College and Hospital, Chandigarh, India
| | - Usha Dalal
- Department of General Surgery, Government Medical College and Hospital, Chandigarh, India
| | - Harsh Mohan
- Department of Pathology, Government Medical College and Hospital, Chandigarh, India
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11
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Kacar A, Paker I, Akcoren Z, Gucer S, Kale G, Orhan D, Talim B, Poyraz A, Uluoglu O, Heper AO, Apaydin S, Arda N, Boduroglu E, Albayrak A, Alper M, Arikok AT. Solid tumors in Turkish children: a multicenter study. World J Pediatr 2013; 9:25-31. [PMID: 22105573 DOI: 10.1007/s12519-011-0323-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Accepted: 06/22/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND This paper presents a detailed incidence study on childhood solid tumors comprising a histopathology-based documentation of benign and malignant lesions. METHODS The Ankara Pediatric Pathology Working Group collected databases of pediatric solid tumors from six pediatric reference centers in order to analyze the incidence, distribution and some epidemiologic characteristics of the tumors and to establish a multicenter database for further studies. A five-year retrospective archive search was carried out. Excluding epithelial tumors of the skin, leukemia, lymphoreticular system neoplasias, metastatic tumors, and hamartomas, 1362 solid tumors in 1358 patients were classified according to age, sex, localization, histopathology and clinical behavior. RESULTS The male/female ratio was 0.9; 14.8% (201) of the patients belonged to 0-1 year age group, 20.7% (281) to 2-4 years, 25.9% (352) to 5-10 years, 22.2% (301) to 11-14 years, and 16.4% (223) to 15-18 years. Among all tumors, 708 (52.0%) were malignant, 645 (47.4%) benign tumors, 2 (0.1%) borderline tumors, and 2 (0.1%) unknown behavioral tumors. Malignant tumors were found in 50.2% (357) of female patients and in 54.0% (349) of male patients. A balanced distribution between benign and malignant entities among children under 18 years was observed. Comparison between the age groups revealed malignant cases outnumbered benign cases under 4 years of age while benign tumor numbers increased after 10 years of age. The most common entities in the malignant group were of sympathetic nervous system origin, while soft tissue tumors far outnumbered the others in the benign group. CONCLUSIONS We conclude that the cancer patterns of children in the Ankara region mostly resemble with those of the western population. This study provides useful information on the diagnosis of solid tumors in children and highlights variations in cancer incidence in different age groups.
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Affiliation(s)
- Ayper Kacar
- Pathology Department, Ankara Child Diseases Hematology Oncology Research and Training Hospital, Ankara, Turkey.
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