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Abstract
Hodgkin lymphoma (HL) commonly occurs in adolescents and young adults (AYA), defined by the National Cancer Institute as people diagnosed with cancer between the ages of 15 and 39 years. Despite therapeutic advances, the AYA population has derived less incremental benefit compared to both paediatric and adult counterparts. Although the exact aetiology is unclear, contributing factors probably include differences in disease biology, delayed diagnosis, decreased participation in clinical trials and treatment adherence secondary to complex social factors. As such, while HL remains highly curable, there is not a clear consensus regarding the management of patients within this age range, specifically whether paediatric or adult regimens are preferred or how best to incorporate emerging therapeutic advancements. Ongoing clinical trials, as well as continued collaborative efforts are required to address the needs of this population, investigate the potential for unique biological factors and allow for optimization of treatment. Here we review current prognostic and treatment strategies for paediatric and adult patients with HL and highlight complexities around the management of this patient population.
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Affiliation(s)
- Jennifer L Crombie
- Department of Medical Oncology, Dana-Farber Cancer Center, Boston, MA, USA
| | - Ann S LaCasce
- Department of Medical Oncology, Dana-Farber Cancer Center, Boston, MA, USA
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152
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Bouaoud J, Temam S, Cozic N, Galmiche-Rolland L, Belhous K, Kolb F, Bidault F, Bolle S, Dumont S, Laurence V, Plantaz D, Tabone MD, Marec-Berard P, Quassemyar Q, Couloigner V, Picard A, Gomez-Brouchet A, Le Deley MC, Mahier-Ait Oukhatar C, Kadlub N, Gaspar N. Ewing's Sarcoma of the Head and Neck: Margins are not just for surgeons. Cancer Med 2018; 7:5879-5888. [PMID: 30449071 PMCID: PMC6308064 DOI: 10.1002/cam4.1801] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 12/18/2022] Open
Abstract
Background, Methods To describe the characteristics, treatments (systemic/local), and outcome (oncological/functional) of French patients with head and neck Ewing's sarcomas (HNES) registered in the Euro‐Ewing 99 (EE99) database. Specific patient‐level data were reviewed retrospective. Results Forty‐seven HNES patients in the EE99 database had a median age of 11 years, 89% had bone tumors (skull 55%, mandible 21%, maxilla 11%), 89% had small tumors (<200 mL), and they were rarely metastatic (9%). Local treatment was surgery radiotherapy (55%), exclusively surgery (28%), or radiotherapy (17%). Metastatic relapses occurred in five patients with high relapse risk factors (metastasis at diagnosis, poor histological response, large tumors). Local progression/relapses (LR) after exclusive radiotherapy occurred in three patients with persistent extra‐osseous residue and in four patients considered R0 margins (postchemotherapy surgery, without postoperative radiotherapy [PORT]), reclassified by pathological review as R1a. Pathological review reclassified 72% of R0 margins: 11/18 to R1a and 2/18 to R2. Five patients had confirmed R0 margins after postchemotherapy surgery without PORT and had no LR Eight patients had R2 margins (initial surgery without previous chemotherapy, with PORT) and had no LR With a median follow‐up of 9.3 years, the 3‐year LR rate, EFS, and OS were 84.8%, 78.6%, and 89.3%, respectively. Among the 5‐year survivors, 88% had long‐term sequelae. Conclusion To optimize HNES management, patients should be treated from diagnosis in expert centers with multidisciplinary committees to discuss treatment strategy (type of surgery, need for PORT) and validate surgical margins.
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Affiliation(s)
- Jebrane Bouaoud
- Unit of maxillofacial and Plastic Surgery, Necker-Enfants Malades, Paris, France
| | - Stephane Temam
- Unit of Head and Neck Surgery, Gustave Roussy, Villejuif, France
| | - Nathalie Cozic
- Department of Biostatistics, Gustave Roussy, Villejuif, France
| | - Louise Galmiche-Rolland
- Department of Pathology, Necker-Enfants Malades, Paris, France.,University Paris Descartes, Paris, France
| | - Kahina Belhous
- University Paris Descartes, Paris, France.,Department of Pediatric Radiology, Necker-Enfants Malades, Paris, France
| | - Frederic Kolb
- Plastic and Reconstructive Surgery Department, Gustave Roussy, Villejuif, France
| | | | - Stephanie Bolle
- Radiation Oncology Department, Gustave Roussy, Villejuif, France
| | - Sarah Dumont
- Department of medical oncology, Gustave Roussy, Villejuif, France
| | | | - Dominique Plantaz
- Department of Pediatric Hematology-Oncology, University Hospital Centre of Grenoble, Grenoble, France
| | | | - Perrine Marec-Berard
- Department of Pediatric Oncology, Léon Bérard Cancer Center, Institute for Paediatric Haematology and Oncology, Lyon, France
| | - Quentin Quassemyar
- Plastic and Reconstructive Surgery Department, Gustave Roussy, Villejuif, France
| | - Vincent Couloigner
- University Paris Descartes, Paris, France.,Unit of Otolaryngology and Head and Neck Surgery, Necker-Enfants Malades, Paris, France
| | - Arnaud Picard
- Unit of maxillofacial and Plastic Surgery, Necker-Enfants Malades, Paris, France.,University Paris Descartes, Paris, France
| | | | - Marie-Cécile Le Deley
- Centre Oscar Lambret, Lille, France.,CESP, INSERM, Fac. de médecine - Univ. Paris-Sud, Université Paris-Saclay, Villejuif, France
| | | | - Natacha Kadlub
- Unit of maxillofacial and Plastic Surgery, Necker-Enfants Malades, Paris, France.,University Paris Descartes, Paris, France
| | - Nathalie Gaspar
- Department of Oncology for Child and Adolescents, Gustave Roussy, Villejuif, France
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153
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Lekshminarayanan A, Bhatt P, Linga VG, Chaudhari R, Zhu B, Dave M, Donda K, Savani S, Patel SV, Billimoria ZC, Bhaskaran S, Zaid-Kaylani S, Dapaah-Siakwan F, Bhatt NS. National Trends in Hospitalization for Fever and Neutropenia in Children with Cancer, 2007-2014. J Pediatr 2018; 202:231-237.e3. [PMID: 30029861 DOI: 10.1016/j.jpeds.2018.06.056] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 06/05/2018] [Accepted: 06/18/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To assess the trends of inpatient resource use and mortality in pediatric hospitalizations for fever with neutropenia in the US from 2007 to 2014. STUDY DESIGN Using National (Nationwide) Inpatient Sample (NIS) and International Classification of Diseases, Ninth Revision, Clinical Modification codes, we studied pediatric cancer hospitalizations with fever with neutropenia between 2007 and 2014. Using appropriate weights for each NIS discharge, we created national estimates of median cost, length of stay, and in-hospital mortality rates. RESULTS Between 2007 and 2014, there were 104 315 hospitalizations for pediatric fever with neutropenia. The number of weighted fever with neutropenia hospitalizations increased from 12.9 (2007) to 18.1 (2014) per 100 000 US population. A significant increase in fever with neutropenia hospitalizations trend was seen in the 5- to 14-year age group, male sex, all races, and in Midwest and Western US hospital regions. Overall mortality rate remained low at 0.75%, and the 15- to 19-year age group was at significantly greater risk of mortality (OR 2.23, 95% CI 1.36-3.68, P = .002). Sepsis, pneumonia, meningitis, and mycosis were the comorbidities with greater risk of mortality during fever with neutropenia hospitalizations. Median length of stay (2007: 4 days, 2014: 5 days, P < .001) and cost of hospitalization (2007: $8771, 2014: $11 202, P < .001) also significantly increased during the study period. CONCLUSIONS Our study provides information regarding inpatient use associated with fever with neutropenia in pediatric hospitalizations. Continued research is needed to develop standardized risk stratification and cost-effective treatment strategies for fever with neutropenia hospitalizations considering increasing costs reported in our study. Future studies also are needed to address the greater observed mortality in adolescents with cancer.
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Affiliation(s)
- Anusha Lekshminarayanan
- Department of Internal Medicine, Functional Cholesterol, Diabetes, and Endocrinology Center, Springdale, OH
| | - Parth Bhatt
- Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, TX
| | - Vijay Gandhi Linga
- Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, TX
| | - Riddhi Chaudhari
- Department of Pediatrics, University of Connecticut, Hartford, CT
| | - Brian Zhu
- Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, TX
| | - Mihir Dave
- Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Keyur Donda
- Department of Pediatrics, University of Miami, Coral Gables, FL
| | - Sejal Savani
- Department of Public Health, New York University, New York, NY
| | - Samir V Patel
- Department of Internal Medicine, Sparks Health Systems, Fort Smith, AR
| | | | - Smita Bhaskaran
- Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, TX
| | - Samer Zaid-Kaylani
- Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, TX
| | | | - Neel S Bhatt
- Department of Pediatrics, Division of Hematology/Oncology/BMT, Medical College of Wisconsin, Milwaukee, WI.
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154
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Creutzig U, Kutny MA, Barr R, Schlenk RF, Ribeiro RC. Acute myelogenous leukemia in adolescents and young adults. Pediatr Blood Cancer 2018; 65:e27089. [PMID: 29667722 PMCID: PMC6105504 DOI: 10.1002/pbc.27089] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/14/2018] [Accepted: 03/16/2018] [Indexed: 12/19/2022]
Abstract
The incidence of acute myelogenous leukemia (AML) increases progressively with age. Favorable genetic mutations are most prevalent in children, and unfavorable profiles increase proportionately in adolescents and young adults (AYA) and into later adulthood. Survival rates of AYA have improved over recent decades to 50-60%, but their accrual to clinical trials remains poor. In contrast to AYA with acute lymphoblastic leukemia, the prognostic benefit for AYA with AML enrolled in pediatric compared with adult trials is minor and only seen when different protocols are used. The distinctive needs of AYA, including intensive psychological services, call for their treatment within specialized centers that offer complex supportive care.
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Affiliation(s)
- Ursula Creutzig
- Pediatric Hematology/Oncology, Hannover Medical School, Hannover, Germany
| | - Matthew A. Kutny
- Department of Pediatrics, Division of Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ronald Barr
- Departments of Pediatrics, Pathology and Medicine, McMaster University, Hamilton, ON, Canada
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155
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Avila JC, Livingston JA, Rodriguez AM, Kirchhoff AC, Kuo YF, Kaul S. Disparities in Adolescent and Young Adult Sarcoma Survival: Analyses of the Texas Cancer Registry and the National SEER Data. J Adolesc Young Adult Oncol 2018; 7:681-687. [PMID: 30096005 DOI: 10.1089/jayao.2018.0034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Examine disparities in survival for adolescents and young adults (AYAs) diagnosed with bone and soft tissue sarcomas in Texas compared with national estimates. METHODS AYAs with sarcomas diagnosed between 1995 and 2012 at ages 15-39 years were identified from the Texas Cancer Registry (TCR) and Surveillance, Epidemiology, and End Results (SEER) program. Patient demographic, treatment, and clinical characteristics were compared between TCR and SEER using chi-squared tests. Five-year survival was computed using the Kaplan-Meier method. Cox proportional hazards (CPH) models evaluated the factors associated with the risk of mortality between and within the two datasets. RESULTS Sarcoma patients in TCR were more likely to be Hispanic, uninsured, diagnosed at late stage, and have lower rates of surgery as the first line of treatment than those in SEER. In Texas, 5-year survival was 68.7% versus 72.2% in SEER (p < 0.001). However, after including surgery in our fully adjusted CPH model, survival differences between the two datasets were no longer observed. In these models, males, and those living in nonmetropolitan areas were more likely to die than their counterparts in both datasets. In TCR, those who lived in the U.S. and Mexico border had higher mortality. In SEER, Hispanics and non-Hispanic blacks had higher mortality. CONCLUSION The adjusted AYA sarcoma survival in Texas was similar to that of SEER, but patients in Texas were more likely to be uninsured and have lower surgery rates. Those living in the U.S. and Mexico border in Texas faced lower survival. These results are important for delineating effective care for this high-risk patient group.
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Affiliation(s)
- Jaqueline C Avila
- 1 Department of Preventive Medicine and Community Health, University of Texas Medical Branch , Galveston, Texas
| | - J Andrew Livingston
- 2 Department of Sarcoma Medical Oncology, University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Ana M Rodriguez
- 3 Department of Obstetrics and Gynecology, University of Texas Medical Branch , Galveston, Texas
| | - Anne C Kirchhoff
- 4 Department of Pediatric Hematology/Oncology and Huntsman Cancer Institute, University of Utah , Salt Lake City, Utah
| | - Yong-Fang Kuo
- 1 Department of Preventive Medicine and Community Health, University of Texas Medical Branch , Galveston, Texas
| | - Sapna Kaul
- 1 Department of Preventive Medicine and Community Health, University of Texas Medical Branch , Galveston, Texas
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156
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Acute lymphoblastic leukemia in adolescent and young adults: treat as adults or as children? Blood 2018; 132:351-361. [DOI: 10.1182/blood-2018-02-778530] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 04/08/2018] [Indexed: 12/21/2022] Open
Abstract
Abstract
Adolescent and young adult (AYA) patients with acute lymphoblastic leukemia (ALL) are recognized as a unique population with specific characteristics and needs. In adolescents age 15 to 20 years, the use of fully pediatric protocols is supported by many comparative studies of pediatric and adult cooperative groups. In young adults, growing evidence suggests that pediatric-inspired or even fully pediatric approaches may also dramatically improve outcomes, leading to long-term survival rates of almost 70%, despite diminishing indications of hematopoietic stem-cell transplantation. In the last decade, better knowledge of the ALL oncogenic landscape according to age distribution and minimal residual disease assessments has improved risk stratification. New targets have emerged, mostly in the heterogeneous B-other group, particularly in the Philadelphia-like ALL subgroup, which requires both in-depth molecular investigations and specific evaluations of targeted treatments. The remaining gap in the excellent results reported in children has many other contributing factors that should not be underestimated, including late or difficult access to care and/or trials, increased acute toxicities, and poor adherence to treatment. Specific programs should be designed to take into account those factors and finally ameliorate survival and quality of life for AYAs with ALL.
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157
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Smith L, Pini S, Ferrari A, Yeomanson D, Hough R, Olsen PR, Gofti-Laroche L, Fleming T, Elliott M, Feltbower R, Kertesz G, Stark D. Pathways to Diagnosis for Teenagers and Young Adults with Cancer in European Nations: A Pilot Study. J Adolesc Young Adult Oncol 2018; 7:604-611. [PMID: 30036113 DOI: 10.1089/jayao.2018.0045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The diagnosis of cancer is often prolonged in teenagers and young adults (TYA). There may be lessons in improving this from international comparisons. However, international studies are complex and so we conducted a pilot study to examine the key barriers to large-scale research in this field. METHODS We provided translated questionnaires covering key aspects of presentation and clinical management within 60 days of a confirmed cancer diagnosis, to patients 13-29 years of age inclusive, to their primary care physicians and to the cancer specialists managing their cancer. We conducted descriptive analyses of the data and also the process of study implementation. RESULTS For our pilot, collecting triangulated data was feasible, but varying regulatory requirements and professional willingness to contribute data were key barriers. The time of data collection and the method for collecting symptom reports were important for timely and accurate data synthesis. Patients reported more symptoms than professionals recorded. We observed substantial variation in pathways to cancer diagnosis to explore definitively in future studies. CONCLUSION Focused research upon the mechanisms underpinning complex cancer pathways, and focusing that research upon specific cancer types within TYA may be the next key areas of study.
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Affiliation(s)
- Lesley Smith
- 1 Clinical and Population Science Department, Leeds Institute for Data Analytics, School of Medicine, University of Leeds , Leeds, United Kingdom
| | - Simon Pini
- 2 Patient-Centered Outcomes Research Group, Bexley Wing, St. James's University Hospital and University of Leeds , Leeds, United Kingdom
| | - Andrea Ferrari
- 3 Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori , Milan, Italy
| | - Daniel Yeomanson
- 4 Sheffield Children's Hospital , Western Bank, Sheffield, United Kingdom
| | - Rachael Hough
- 5 Department of Adolescent Hematology, University College Hospitals NHS Foundation Trust , London, United Kingdom
| | - Pia Riis Olsen
- 6 Department of Oncology, Aarhus University Hospital , Aarhus, Denmark
| | - Leila Gofti-Laroche
- 7 Teenagers and Young Adults with Cancer Team, University of Grenoble Alpes , CHU Grenoble Alpes, Grenoble, France
| | - Thomas Fleming
- 1 Clinical and Population Science Department, Leeds Institute for Data Analytics, School of Medicine, University of Leeds , Leeds, United Kingdom
| | - Martin Elliott
- 8 Second Department of Pediatrics, Semmelweis University , Budapest, Hungary
| | - Richard Feltbower
- 1 Clinical and Population Science Department, Leeds Institute for Data Analytics, School of Medicine, University of Leeds , Leeds, United Kingdom
| | - Gabriella Kertesz
- 8 Second Department of Pediatrics, Semmelweis University , Budapest, Hungary
| | - Dan Stark
- 9 Teenage and Young Adult Cancer Services, Institute of Oncology , Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
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158
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Landier W, Skinner R, Wallace WH, Hjorth L, Mulder RL, Wong FL, Yasui Y, Bhakta N, Constine LS, Bhatia S, Kremer LC, Hudson MM. Surveillance for Late Effects in Childhood Cancer Survivors. J Clin Oncol 2018; 36:2216-2222. [PMID: 29874139 PMCID: PMC6804892 DOI: 10.1200/jco.2017.77.0180] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Many childhood cancer survivors carry a significant risk for late morbidity and mortality, a consequence of the numerous therapeutic exposures that contribute to their cure. Focused surveillance for late therapy-related complications provides opportunities for early detection and implementation of health-preserving interventions. The substantial body of research that links therapeutic exposures used during treatment of childhood cancer to adverse outcomes among survivors enables the characterization of groups at the highest risk for developing complications related to specific therapies; however, methods available to optimize screening strategies to detect these therapy-related complications are limited. Moreover, the feasibility of conducting clinical trials to test screening recommendations for childhood cancer survivors is limited by requirements for large sample sizes, lengthy study periods, prohibitive costs, and ethical concerns. In addition, the harms of screening should be considered, including overdiagnosis and psychological distress. Experts in several countries have developed guideline recommendations for late effects surveillance and have collaborated to harmonize these recommendations internationally to enhance long-term follow-up care and quality of life for childhood cancer survivors. Methods used in these international efforts include systematic literature searches, development of evidence-based summaries, rigorous evaluation of the evidence, and formulation of consensus-based surveillance recommendations for each late complication. Alternate methods to refine recommendations, such as cumulative burden assessment and risk prediction and cost-effectiveness modeling, may provide novel approaches to guide survivorship care in this vulnerable population and, thus, represents a worthy objective for future international survivorship collaborations.
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Affiliation(s)
- Wendy Landier
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Roderick Skinner
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - W. Hamish Wallace
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Lars Hjorth
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Renée L. Mulder
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - F. Lennie Wong
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Yutaka Yasui
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Nickhill Bhakta
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Louis S. Constine
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Smita Bhatia
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Leontien C. Kremer
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Melissa M. Hudson
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
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Ferrari A, Bleyer A, Patel S, Chiaravalli S, Gasparini P, Casanova M. The challenge of the management of adolescents and young adults with soft tissue sarcomas. Pediatr Blood Cancer 2018; 65:e27013. [PMID: 29493075 DOI: 10.1002/pbc.27013] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/16/2018] [Accepted: 01/24/2018] [Indexed: 01/14/2023]
Abstract
Soft tissue sarcomas are relatively frequent in adolescents and young adults and their clinical management may be complex, partly due to tumor associated factors, but also because different approaches have been adopted by pediatric and adult medical oncologists dealing with the same disease. However, times are changing and in the last few years, management has tended to converge towards a common strategy. Continued and increased international collaboration between pediatric and adult sarcoma groups is of critical importance to improve the quality of treatment as well as research programs dedicated to young patients with soft tissue sarcomas.
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Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Archie Bleyer
- Department of Radiation Medicine, Oregon Health and Sciences University, Portland, Oregon
| | - Shreyaskumar Patel
- Department of Sarcoma Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Stefano Chiaravalli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Patrizia Gasparini
- Tumor Genomics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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160
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Roder DM, Warr A, Patterson P, Allison KR. Australian Adolescents and Young Adults: Trends in Cancer Incidence, Mortality, and Survival Over Three Decades. J Adolesc Young Adult Oncol 2018; 7:326-338. [DOI: 10.1089/jayao.2017.0095] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- David M. Roder
- Cancer Epidemiology Research Group, Centre for Population Research, Samson Institute for Health Research, University of South Australia, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | | | - Pandora Patterson
- CanTeen Australia, Sydney, Australia
- Cancer Nursing Research Unit, University of Sydney, Sydney, Australia
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161
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Hughes N, Stark D. The management of adolescents and young adults with cancer. Cancer Treat Rev 2018; 67:45-53. [PMID: 29753962 DOI: 10.1016/j.ctrv.2018.05.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/03/2018] [Accepted: 05/04/2018] [Indexed: 12/11/2022]
Abstract
Adolescents and Young Adults (AYA) with cancer are young people developing serious illness when at the interface between the responsibilities of paediatric and adult cancer services. Personally, they are in a period of transition both biologically and in major social roles (Sawyer et al., 2018) [1]. For these and other reasons they present a unique set of clinical challenges in their management. Over the last 20 years the requirement for specific services to address their needs has been identified and this has become a growing field of research. Despite this survival rates still lag behind those of children and older adults with cancer (Gatta et al., 2009) [2]. Why do AYA patients have worse outcomes? The observation is that the reason is multifactorial with path to diagnosis, unique cancer biology, uncertainty of treatment protocol, compliance issues and poor recruitment to clinical trials all playing a part. In this review we will discuss the unique challenges faced by healthcare professionals when managing AYA patients who are commonly and accurately described as being in an 'interface' position.
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Affiliation(s)
- Nicola Hughes
- Leeds Institute of Cardiovascular and Molecular Medicine, University of Leeds, UK.
| | - Dan Stark
- Leeds Institute of Cancer and Pathology, St James's Institute of Oncology, Beckett Street, Leeds, UK
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162
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Suzuki Y, Yano T, Suehiro Y, Iwasaki H, Hidaka M, Otsuka M, Sunami K, Inoue N, Sawamura M, Ito T, Iida H, Nagai H. Clinical characteristics and outcomes of diffuse large B-cell lymphoma in adolescents and young adults. Int J Hematol 2018; 108:161-166. [DOI: 10.1007/s12185-018-2449-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 03/26/2018] [Accepted: 03/26/2018] [Indexed: 12/31/2022]
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163
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Whelan J, Hackshaw A, McTiernan A, Grimer R, Spooner D, Bate J, Ranft A, Paulussen M, Juergens H, Craft A, Lewis I. Survival is influenced by approaches to local treatment of Ewing sarcoma within an international randomised controlled trial: analysis of EICESS-92. Clin Sarcoma Res 2018; 8:6. [PMID: 29610659 PMCID: PMC5877389 DOI: 10.1186/s13569-018-0093-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 02/07/2018] [Indexed: 12/25/2022] Open
Abstract
Background Two national clinical trial groups, United Kingdom Children’s Cancer and Leukaemia Group (CCLG) and the German Paediatric Oncology and Haematology Group (GPOH) together undertook a randomised trial, EICESS-92, which addressed chemotherapy options for Ewing’s sarcoma. We sought the causes of unexpected survival differences between the study groups. Methods 647 patients were randomised. Cox regression analyses were used to compare event-free survival (EFS) and overall survival (OS) between the two study groups. Results 5-year EFS rates were 43% (95% CI 36–50%) and 57% (95% CI 52–62) in the CCLG and GPOH patients, respectively; corresponding 5-year OS rates were 52% (95% CI 45–59%) and 66% (95% CI 61–71). CCLG patients were less likely to have both surgery and radiotherapy (18 vs. 59%), and more likely to have a single local therapy modality compared to the GPOH patients (72 vs. 35%). Forty-five percent of GPOH patients had pre-operative radiotherapy compared to 3% of CCLG patients. In the CCLG group local recurrence (either with or without metastases) was the first event in 22% of patients compared with 7% in the GPOH group. After allowing for the effects of age, metastases, primary site, histology and local treatment modality, the risk of an EFS event was 44% greater in the CCLG cohort (95% CI 10–89%, p = 0.009), and the risk of dying was 30% greater, but not statistically significant (95% CI 3–74%, p = 0.08). Conclusions Unexpected differences in EFS and OS occurred between two patient cohorts recruited within an international randomised trial. Failure to select or deliver appropriate local treatment modalities for Ewing’s sarcoma may compromise chances of cure. Trial registration Supported by Deutsche Krebshilfe (Grants No. DKH M43/92/Jü2 and DKH 70-2551 Jü3), and European Union Biomedicine and Health Programme (Grants No. BMH1-CT92-1341 and BMH4-983956), and Cancer Research United Kingdom. Clinical trial information can be found for the following: NCT0000251
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Affiliation(s)
- Jeremy Whelan
- 1Department of Oncology, University College Hospitals London NHS Foundation Trust, 250 Euston Road, London, NW1 2PG UK.,3Children's Cancer and Leukaemia Group Data Centre, Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK
| | - Allan Hackshaw
- 2Cancer Research UK and UCL Clinical Trials Centre, University College London, London, UK
| | - Anne McTiernan
- 1Department of Oncology, University College Hospitals London NHS Foundation Trust, 250 Euston Road, London, NW1 2PG UK
| | | | | | - Jessica Bate
- 1Department of Oncology, University College Hospitals London NHS Foundation Trust, 250 Euston Road, London, NW1 2PG UK
| | | | - Michael Paulussen
- 7Vestische Kinder- und Jugendklinik Datteln, University Witten/Herdecke, Datteln, Germany
| | - Herbert Juergens
- 8Department of Pediatric Hematology and Oncology, University Children's Hospital Münster, Münster, Germany
| | - Alan Craft
- 3Children's Cancer and Leukaemia Group Data Centre, Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK.,9Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - Ian Lewis
- 3Children's Cancer and Leukaemia Group Data Centre, Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK.,10University of Leeds and Leeds Community Healthcare Trust, Leeds, UK
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164
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Harju E, Roser K, Dehler S, Michel G. Health-related quality of life in adolescent and young adult cancer survivors. Support Care Cancer 2018; 26:3099-3110. [DOI: 10.1007/s00520-018-4151-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/05/2018] [Indexed: 01/18/2023]
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165
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Le Nail LR, Brennan M, Rosset P, Deschaseaux F, Piloquet P, Pichon O, Le Caignec C, Crenn V, Layrolle P, Hérault O, De Pinieux G, Trichet V. Comparison of Tumor- and Bone Marrow-Derived Mesenchymal Stromal/Stem Cells from Patients with High-Grade Osteosarcoma. Int J Mol Sci 2018; 19:E707. [PMID: 29494553 PMCID: PMC5877568 DOI: 10.3390/ijms19030707] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 02/10/2018] [Accepted: 02/12/2018] [Indexed: 01/09/2023] Open
Abstract
Osteosarcoma (OS) is suspected to originate from dysfunctional mesenchymal stromal/stem cells (MSC). We sought to identify OS-derived cells (OSDC) with potential cancer stem cell (CSC) properties by comparing OSDC to MSC derived from bone marrow of patients. This study included in vitro characterization with sphere forming assays, differentiation assays, cytogenetic analysis, and in vivo investigations of their tumorigenicity and tumor supportive capacities. Primary cell lines were isolated from nine high-grade OS samples. All primary cell lines demonstrated stromal cell characteristics. Compared to MSC, OSDC presented a higher ability to form sphere clones, indicating a potential CSC phenotype, and were more efficient at differentiation towards osteoblasts. None of the OSDC displayed the complex chromosome rearrangements typical of high grade OS and none of them induced tumors in immunodeficient mice. However, two OSDC demonstrated focused genomic abnormalities. Three out of seven, and six out of seven OSDC showed a supportive role on local tumor development, and on metastatic progression to the lungs, respectively, when co-injected with OS cells in nude mice. The observation of OS-associated stromal cells with rare genetic abnormalities and with the capacity to sustain tumor progression may have implications for future tumor treatments.
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Affiliation(s)
- Louis-Romée Le Nail
- Laboratoire d'étude des sarcomes osseux et remodelage des tissus calcifiés, INSERM UMR 1238, Université de Nantes, PhyOS, 44034 Nantes CEDEX 1, France.
- Centre Hospitalier Régional Universitaire de Tours, Service de Chirurgie Orthopédique 2, Faculté de Médecine de Tours, Université de Tours, 37044 CEDEX 9 Tours, France.
| | - Meadhbh Brennan
- Laboratoire d'étude des sarcomes osseux et remodelage des tissus calcifiés, INSERM UMR 1238, Université de Nantes, PhyOS, 44034 Nantes CEDEX 1, France.
- Harvard School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA.
| | - Philippe Rosset
- Laboratoire d'étude des sarcomes osseux et remodelage des tissus calcifiés, INSERM UMR 1238, Université de Nantes, PhyOS, 44034 Nantes CEDEX 1, France.
- Centre Hospitalier Régional Universitaire de Tours, Service de Chirurgie Orthopédique 2, Faculté de Médecine de Tours, Université de Tours, 37044 CEDEX 9 Tours, France.
| | - Frédéric Deschaseaux
- STROMA Lab, INSERM U1031, Etablissement Français du Sang Occitanie, Université de Toulouse, 31432 Toulouse, France.
| | - Philippe Piloquet
- Centre Hospitalier Universitaire de Nantes, Service de Génétique Médicale, Faculté de Médecine de Nantes, 44034 CEDEX 1 Nantes, France.
| | - Olivier Pichon
- Centre Hospitalier Universitaire de Nantes, Service de Génétique Médicale, Faculté de Médecine de Nantes, 44034 CEDEX 1 Nantes, France.
| | - Cédric Le Caignec
- Laboratoire d'étude des sarcomes osseux et remodelage des tissus calcifiés, INSERM UMR 1238, Université de Nantes, PhyOS, 44034 Nantes CEDEX 1, France.
- Centre Hospitalier Universitaire de Nantes, Service de Génétique Médicale, Faculté de Médecine de Nantes, 44034 CEDEX 1 Nantes, France.
| | - Vincent Crenn
- Laboratoire d'étude des sarcomes osseux et remodelage des tissus calcifiés, INSERM UMR 1238, Université de Nantes, PhyOS, 44034 Nantes CEDEX 1, France.
- Centre Hospitalier Universitaire de Nantes, Service de Chirurgie Orthopédique, Faculté de Médecine de Nantes, Université de Nantes, 44034 CEDEX 1 Nantes, France.
| | - Pierre Layrolle
- Laboratoire d'étude des sarcomes osseux et remodelage des tissus calcifiés, INSERM UMR 1238, Université de Nantes, PhyOS, 44034 Nantes CEDEX 1, France.
| | - Olivier Hérault
- Centre Hospitalier Régional Universitaire de Tours, Service d'Hématologie Biologique, 37044 CEDEX 9 Tours, France.
- National Center for Scientific Research (CNRS) GDR 3697, 75020 Paris, France.
- National Center for Scientific Research (CNRS) ERL 7001 LNOx, 37032 CEDEX 1 Tours, Université de Tours, 37044 Tours, France.
| | - Gonzague De Pinieux
- Laboratoire d'étude des sarcomes osseux et remodelage des tissus calcifiés, INSERM UMR 1238, Université de Nantes, PhyOS, 44034 Nantes CEDEX 1, France.
- Centre Hospitalier Régional Universitaire de Tours, Hôpital Trousseau, Service d'Anatomie Pathologique, Faculté de Médecine de Tours, Université de Tours, 37044 CEDEX 9 Tours, France.
| | - Valérie Trichet
- Laboratoire d'étude des sarcomes osseux et remodelage des tissus calcifiés, INSERM UMR 1238, Université de Nantes, PhyOS, 44034 Nantes CEDEX 1, France.
- National Center for Scientific Research (CNRS) GDR 3697, 75020 Paris, France.
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166
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Krawczuk-Rybak M, Panasiuk A, Stachowicz-Stencel T, Zubowska M, Skalska-Sadowska J, Sęga-Pondel D, Czajńska-Deptuła A, Sławińska D, Badowska W, Kamieńska E, Pobudejska-Pieniążek A, Wieczorek M. Health status of Polish children and adolescents after cancer treatment. Eur J Pediatr 2018; 177:437-447. [PMID: 29273944 PMCID: PMC5816766 DOI: 10.1007/s00431-017-3066-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 12/01/2017] [Accepted: 12/06/2017] [Indexed: 11/26/2022]
Abstract
In the last 40 years, considerable progress was made in the treatment of childhood cancer. Nearly 80% of children achieve long-term clinical remission or are permanently cured. This improvement is however not without sacrifice. This is the first Polish study analyzing the general health status and epidemiology of organ late effects in the cohort of Polish childhood and adolescent cancer survivors monitored by doctors and registered in the on-line national database for late effects (N = 1761). This tool collects information on previous therapy and current health status (medical history, physical examination, laboratory tests) of cancer survivors. The survivors are invited to take part in the follow-up examination 5 years after the end of treatment. In the study group, 207 survivors (11.75%) had no complaints; whereas in 1554 cases (88.25%), one or more symptoms/complaints suggesting organ dysfunction were reported. In the whole group, the circulatory problems were most common (31.7%); more than 20% of survivors presented complaints or abnormal function of the urinary tract and had skin, dental, skeletal/muscular problems, or difficulty with chewing. Obesity or short stature alone (21.4%) and a variety of endocrine problems (short stature, obesity, thyroid dysfunction, and gonads toxicity) were present in 323 patients (118 females 15.0% and 205 males 21.0%). Gonadal dysfunction, as the only problem, occurred in 75 girls (9.6%) and 131 boys (13.4%). In our cohort, severe or life-threatening health conditions (3 and 4 grade according to toxicity criteria) were present in low percentage, i.e., 0.2% in the circulatory system, 0.3% in the respiratory tract and, 0.7% in kidney insufficiency. CONCLUSION Our findings indicate that many childhood cancer survivors demonstrate numerous complaints, even a short time after treatment, suggesting the importance of regular follow-up examinations in subsequent years. What is Known: • Contemporary studies indicate that a significant number of childhood cancer survivors present different long-term side effects which influence their quality of life. What is New: • This is the first nationwide study performed in the largest cohort of Polish childhood cancer survivors concerning general health status and frequency of organ dysfunction.
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Affiliation(s)
- Maryna Krawczuk-Rybak
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Białystok, Poland
| | - Anna Panasiuk
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Białystok, Poland
| | | | - Małgorzata Zubowska
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Lodz, Poland
| | - Jolanta Skalska-Sadowska
- Department of Pediatric Oncology, Hematology and Transplantology University of Medical Sciences, Poznan, Poland
| | - Dorota Sęga-Pondel
- Department of Bone Marrow Transplantation, Oncology and Hematology, Medical University of Wroclaw, Wroclaw, Poland
| | | | - Dorota Sławińska
- Department of Hematology, Oncology and Pediatric Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Wanda Badowska
- Department of Pediatric Oncology and Hematology, County Hospital, Olsztyn, Poland
| | - Elżbieta Kamieńska
- Department of Pediatrics, Hematology and Oncology, Medical University of Szczecin, Szczecin, Poland
| | | | - Maria Wieczorek
- Center of Pediatrics and Oncology by Dr E. Hanke, Chorzow, Poland
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167
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Marques da Costa ME, Daudigeos-Dubus E, Gomez-Brouchet A, Bawa O, Rouffiac V, Serra M, Scotlandi K, Santos C, Geoerger B, Gaspar N. Establishment and characterization of in vivo orthotopic bioluminescent xenograft models from human osteosarcoma cell lines in Swiss nude and NSG mice. Cancer Med 2018; 7:665-676. [PMID: 29473324 PMCID: PMC5852344 DOI: 10.1002/cam4.1346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 12/21/2017] [Accepted: 12/26/2017] [Indexed: 01/14/2023] Open
Abstract
Osteosarcoma is one of the most common primary bone tumors in childhood and adolescence. Metastases occurrence at diagnosis or during disease evolution is the main therapeutic challenge. New drug evaluation to improve patient survival requires the development of various preclinical models mimicking at best the complexity of the disease and its metastatic potential. We describe here the development and characteristics of two orthotopic bioluminescent (Luc/mKate2) cell‐derived xenograft (CDX) models, Saos‐2‐B‐Luc/mKate2‐CDX and HOS‐Luc/mKate2‐CDX, in different immune (nude and NSG mouse strains) and bone (intratibial and paratibial with periosteum activation) contexts. IVIS SpectrumCT system allowed both longitudinal computed tomography (CT) and bioluminescence real‐time follow‐up of primary tumor growth and metastatic spread, which was confirmed by histology. The murine immune context influenced tumor engraftment, primary tumor growth, and metastatic spread to lungs, bone, and spleen (an unusual localization in humans). Engraftment in NSG mice was found superior to that found in nude mice and intratibial bone environment more favorable to engraftment compared to paratibial injection. The genetic background of the two CDX models also led to distinct primary tumor behavior observed on CT scan. Saos‐2‐B‐Luc/mKate2‐CDX showed osteocondensed, HOS‐Luc/mKate2‐CDX osteolytic morphology. Bioluminescence defined a faster growth of the primary tumor and metastases in Saos‐2‐B‐Luc/mKate2‐CDX than in HOS‐Luc/mKate2‐CDX. The early detection of primary tumor growth and metastatic spread by bioluminescence allows an improved exploration of osteosarcoma disease at tumor progression, and metastatic spread, as well as the evaluations of anticancer treatments. Our orthotopic models with metastatic spread bring complementary information to other types of existing osteosarcoma models.
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Affiliation(s)
- Maria Eugenia Marques da Costa
- Vectorology and Anticancer Therapies, UMR 8203, CNRS, University of Paris-Sud, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,CESAM & Department of Biology, University of Aveiro, Aveiro, Portugal
| | - Estelle Daudigeos-Dubus
- Vectorology and Anticancer Therapies, UMR 8203, CNRS, University of Paris-Sud, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Anne Gomez-Brouchet
- Department of Pathology, IUCT-Oncopole, CHU of Toulouse and University of Toulouse, Toulouse, France.,Pharmacology and Structural Biology Institut, CNRS UMR5089, Toulouse, France
| | - Olivia Bawa
- Plateforme HistoCytoPathologie, UMS AMMICa, Gustave Roussy, Villejuif, France
| | - Valerie Rouffiac
- Imaging and Cytometry Platform, UMS 3655& US23, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Massimo Serra
- Laboratory of Experimental Oncology, Orthopaedic Rizzoli Institute, Bologna, Italy
| | - Katia Scotlandi
- Laboratory of Experimental Oncology, Orthopaedic Rizzoli Institute, Bologna, Italy
| | - Conceição Santos
- Department of Biology, Faculty of Sciences, University of Porto, Porto, Portugal
| | - Birgit Geoerger
- Vectorology and Anticancer Therapies, UMR 8203, CNRS, University of Paris-Sud, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Department of Oncologie for child and adolescent, Gustave Roussy, Villejuif, France
| | - Nathalie Gaspar
- Vectorology and Anticancer Therapies, UMR 8203, CNRS, University of Paris-Sud, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Department of Oncologie for child and adolescent, Gustave Roussy, Villejuif, France
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168
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Borinstein SC, Steppan D, Hayashi M, Loeb DM, Isakoff MS, Binitie O, Brohl AS, Bridge JA, Stavas M, Shinohara ET, Meyer WH, Reed DR, Wagner LM. Consensus and controversies regarding the treatment of rhabdomyosarcoma. Pediatr Blood Cancer 2018; 65. [PMID: 28905489 DOI: 10.1002/pbc.26809] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 07/28/2017] [Accepted: 08/10/2017] [Indexed: 12/20/2022]
Abstract
Optimal treatment of rhabdomyosarcoma (RMS) requires multidisciplinary approach, incorporating chemotherapy with local control. Although current therapies are built on cooperative group trials, a comprehensive standard of care to guide clinical decision making has been lacking, especially for relapsed patients. Therefore, we assembled a panel of pediatric and adolescent and young adult sarcoma experts to develop treatment guidelines for managing RMS and to identify areas in which further research is needed. We created algorithms incorporating evidence-based care for patients with RMS, emphasizing the importance of clinical trials and close integration of all specialties involved in the care of these patients.
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Affiliation(s)
- Scott C Borinstein
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Diana Steppan
- Division of Pediatric Oncology, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| | - Masanori Hayashi
- Division of Pediatric Oncology, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| | - David M Loeb
- Division of Pediatric Oncology, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| | - Michael S Isakoff
- Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, Hartford, Connecticut
| | - Odion Binitie
- Sarcoma Department, Adolescent and Young Adult Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Andrew S Brohl
- Sarcoma Department, Adolescent and Young Adult Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Julia A Bridge
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Mark Stavas
- Division of Radiation Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Eric T Shinohara
- Division of Radiation Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - William H Meyer
- Jimmy Everest Section of Pediatric Hematology/Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Damon R Reed
- Sarcoma Department, Adolescent and Young Adult Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Lars M Wagner
- Division of Pediatric Hematology/Oncology, University of Kentucky, Lexington, Kentucky
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169
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Thewes B, Kaal SEJ, Custers JAE, Manten-Horst E, Jansen R, Servaes P, van der Graaf WTA, Prins JB, Husson O. Prevalence and correlates of high fear of cancer recurrence in late adolescents and young adults consulting a specialist adolescent and young adult (AYA) cancer service. Support Care Cancer 2017; 26:1479-1487. [PMID: 29168035 PMCID: PMC5876258 DOI: 10.1007/s00520-017-3975-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 11/13/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE High fear of cancer recurrence (FCR) is a frequently reported problem among cancer patients. Previous research has shown that younger age is associated with higher levels of FCR. However, little attention has been given to date about how FCR manifests itself among adolescent and young adult (AYA) cancer patients. This study explores the prevalence, correlates of high FCR, and its association with HRQoL in cancer patients in their late adolescence or young adulthood. METHODS Seventy-three AYA cancer patients, aged 18-35 years at diagnosis, consulted the AYA team of the Radboud University Medical Center completed questionnaires including the Cancer Worry Scale (CWS), Quality of Life-Cancer Survivors (QOL-CS), and Hospital Anxiety and Depression Scale (HADS). Sociodemographic and medical data was collected by self-reported questionnaire. RESULTS Forty-five participants experienced high FCR (62%), which was higher than the 31-52% reported in previous studies among mixed adult cancer patient samples. Sociodemographic and medical variables were not associated with levels of FCR. High FCR was significantly associated with lower levels of social and psychological functioning and overall HRQoL and higher levels of anxiety and psychological distress. CONCLUSION Results illustrate that FCR is a significant problem among AYA cancer patients consulting an AYA team, with participants reporting higher levels of FCR than cancer patients of mixed ages. Health care providers should pay specific attention to this problem by screening and the provision of appropriate psychosocial care when needed.
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Affiliation(s)
- Belinda Thewes
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands.
| | - Suzanne E J Kaal
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jose A E Custers
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Eveliene Manten-Horst
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Rosemarie Jansen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Petra Servaes
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Winette T A van der Graaf
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Judith B Prins
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Olga Husson
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
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170
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Pattern of hematological malignancies in adolescents and young adults in Bangladesh. Cancer Epidemiol 2017; 51:109-112. [PMID: 29121606 DOI: 10.1016/j.canep.2017.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 10/26/2017] [Accepted: 11/01/2017] [Indexed: 01/28/2023]
Abstract
INTRODUCTION The adolescent and young adult (AYA) age group (15-39 years) bears distinct characteristics in terms of cancer biology, long-term health and treatment-related complications and psychosocial aspects. The overall scenario of cancer including hematological malignancies (HMs) is largely unknown in Bangladesh, where a significant proportion of people (44% of total population) belong to AYA age group. This study aims to describe the patterns of HM among AYA in the context of Bangladesh METHODS: Two previously published datasets (on hematological malignancies and childhood and adolescent cancer) were merged to construct a comprehensive dataset focusing exclusively on HMs in AYA age group. Univariate descriptive statistics were calculated and bivariate association were tested using Pearson's Chi-square test. RESULTS A total of 2144 diagnosed HM related cases over a period of 2007-2014 were analyzed. Acute myeloid leukemia (AML) was the most frequent HM (35.1%) in AYAs, which was followed by acute lymphoblastic leukemia (ALL) and chronic myeloid leukemia (CML) constituting 22.7% and 20.8%, respectively. Among lymphomas, Non-Hodgkin lymphoma (NHL) constituted 13.9% of all HMs while 4.6% was for Hodgkin's lymphoma (HL). CONCLUSION This is the first attempt to provide a glimpse on the pattern and distribution of HMs among AYA in Bangladesh. Future studies are essential to get a better insight on the epidemiology, biology, potential risk factors and treatment outcomes for the AYA age group.
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171
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Meier M, Orr N. Genetic Determinants of Breast Cancer Risk in Childhood Cancer Survivors. J Natl Cancer Inst 2017; 109:3855141. [PMID: 29059431 PMCID: PMC5445946 DOI: 10.1093/jnci/djx088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 04/10/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- Magda Meier
- Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Nick Orr
- Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
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172
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Preclinical Testing of an Oncolytic Parvovirus: Standard Protoparvovirus H-1PV Efficiently Induces Osteosarcoma Cell Lysis In Vitro. Viruses 2017; 9:v9100301. [PMID: 29039746 PMCID: PMC5691652 DOI: 10.3390/v9100301] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 09/22/2017] [Accepted: 09/26/2017] [Indexed: 01/05/2023] Open
Abstract
Osteosarcoma is the most frequent malignant disease of the bone. On the basis of early clinical experience in the 1960s with H-1 protoparvovirus (H-1PV) in osteosarcoma patients, this effective oncolytic virus was selected for systematic preclinical testing on various osteosarcoma cell cultures. A panel of five human osteosarcoma cell lines (CAL 72, H-OS, MG-63, SaOS-2, U-2OS) was tested. Virus oncoselectivity was confirmed by infecting non-malignant human neonatal fibroblasts and osteoblasts used as culture models of non-transformed mesenchymal cells. H-1PV was found to enter osteosarcoma cells and to induce viral DNA replication, transcription of viral genes, and translation to viral proteins. After H-1PV infection, release of infectious viral particles from osteosarcoma cells into the supernatant indicated successful viral assembly and egress. Crystal violet staining revealed progressive cytomorphological changes in all osteosarcoma cell lines. Infection of osteosarcoma cell lines with the standard H-1PV caused an arrest of the cell cycle in the G2 phase, and these lines had a limited capacity for standard H-1PV virus replication. The cytotoxicity of wild-type H-1PV virus towards osteosarcoma cells was compared in vitro with that of two variants, Del H-1PV and DM H-1PV, previously described as fitness variants displaying higher infectivity and spreading in human transformed cell lines of different origins. Surprisingly, wild-type H-1PV displayed the strongest cytostatic and cytotoxic effects in this analysis and thus seems the most promising for the next preclinical validation steps in vivo.
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173
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Saloustros E, Stark DP, Michailidou K, Mountzios G, Brugieres L, Peccatori FA, Jezdic S, Essiaf S, Douillard JY, Bielack S. The care of adolescents and young adults with cancer: results of the ESMO/SIOPE survey. ESMO Open 2017; 2:e000252. [PMID: 29018578 PMCID: PMC5604713 DOI: 10.1136/esmoopen-2017-000252] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 08/10/2017] [Accepted: 08/11/2017] [Indexed: 11/22/2022] Open
Abstract
Introduction Adolescents and young adults (AYA) with cancer require dedicated clinical management and care. Little is known about the training and practice of European healthcare providers in regard to AYA and the availability of specialised services. Methods A link to an online survey was sent to members of the European Society for Medical Oncology (ESMO) and the European Society for Paediatric Oncology (SIOPE). The link was also sent to ESMO National Representatives and circulated to other European oncology groups. Questions covered the demographics and clinical training of respondents, their definition of AYA, education about AYA cancer, access to specialised clinical and supportive care, research and further education. Data from Europe were analysed by region. Results Three hundred tweenty two questionnaires were submitted and we focused on data from the 266 European healthcare professionals. Responses revealed considerable variation both within and between countries in the definition of AYA. Over two-thirds of respondents did not have access to specialised centres for AYA (67%), were not aware of research initiatives focusing on AYA with cancer (69%) and had no access to specialist services for managing the late effects of treatment (67%). The majority of the respondents were able to refer AYA patients to professional psychological support and specialised social workers. However, more than half had no access to an age-specialised nurse or specialised AYA education. Overall, 38% of respondents reported that their AYA patients did not have access to fertility specialists. This figure was 76% in Eastern Europe. Lack of specialised AYA care was particularly evident in Eastern and South-Eastern Europe. Conclusion There is important underprovision and inequity of AYA cancer care across Europe. Improving education and research focused on AYA cancer care should be a priority.
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Affiliation(s)
- Emmanouil Saloustros
- Oncology Unit, General Hospital of Heraklion 'Venizelio', Heraklion, Crete, Greece
| | | | | | - Giannis Mountzios
- Department of Medical Oncology, 251 General Airforce Hospital, Athens, Greece
| | | | - Fedro Alessandro Peccatori
- Fertility & Procreation Unit, Gynecologic Oncology Department, European Institute of Oncology, Milan, Italy
| | - Svetlana Jezdic
- European Society for Medical Oncology, Viganello-Lugano, Switzerland
| | - Samira Essiaf
- European Society for Paediatric Oncology (SIOPE), Brussels, Belgium
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174
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Ferrari A, Barr RD. International evolution in AYA oncology: Current status and future expectations. Pediatr Blood Cancer 2017; 64. [PMID: 28370975 DOI: 10.1002/pbc.26528] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/02/2017] [Accepted: 02/15/2017] [Indexed: 01/22/2023]
Abstract
Adolescents and Young Adults (AYAs) contribute approximately 1 million incident cases globally, but the great majority are underserved. In high-income countries, overall survival exceeds 80%, but the needs of this population during and after their treatment experience are poorly met, though specialized clinical programs are evolving. Engagement of national governments is advantageous and deployment of multidisciplinary teams essential. Collaboration between pediatric and adult healthcare providers is mandatory and AYAs must be given a strong voice in program development. Building and sharing international experience will hasten advances in clinical care, education, and research, while a focus on developing countries is a worthy challenge.
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Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nationale dei Tumori, Milan, Italy
| | - Ronald D Barr
- Departments of Pediatrics, Pathology and Medicine, McMaster University, Hamilton, Ontario, Canada
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175
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Boissel N. How should we treat the AYA patient with newly diagnosed ALL? Best Pract Res Clin Haematol 2017; 30:175-183. [PMID: 29050690 DOI: 10.1016/j.beha.2017.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 07/31/2017] [Accepted: 07/31/2017] [Indexed: 01/19/2023]
Abstract
Adolescent and young adult (AYA) patients with acute lymphoblastic leukaemia (ALL) are recognized as a unique population with specific characteristics and needs. In adolescents aged 15-20 years old, the use of full paediatric protocols is supported by many comparative studies of paediatric and adult cooperative groups. In young adults, growing evidence suggests that paediatric-inspired approaches may also improve outcomes and lead to long-term survival rates of almost 70%. In the last decade, better knowledge of ALL oncogenic landscape, age distribution, and minimal residual disease prognostic impact have improved risk stratification. New targets have emerged mostly in the heterogeneous subgroup of Philadelphia-like ALL and will require both in-depth molecular investigations and specific evaluations in rare subgroups of ALL. The remaining gap with the excellent results reported in children has many other contributing factors that should not be underestimated including late or difficult access to care, or poor adherence to treatment.
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Affiliation(s)
- Nicolas Boissel
- Adolescent & Young Adult Hematology Unit, Saint-Louis Hospital, EA-3518, Paris 7 University, 1 avenue Claude Vellefaux, 75010, Paris, France.
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176
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May EA, McGill BC, Robertson EG, Anazodo A, Wakefield CE, Sansom-Daly UM. Adolescent and Young Adult Cancer Survivors' Experiences of the Healthcare System: A Qualitative Study. J Adolesc Young Adult Oncol 2017; 7:88-96. [PMID: 28737997 DOI: 10.1089/jayao.2017.0015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To qualitatively examine the experiences of diagnosis and treatment, and attitudes toward ongoing healthcare of adolescent and young adult (AYA) survivors of AYA cancer, to determine barriers to healthcare engagement in the early survivorship period. METHODS Forty-two participants aged between 15 and 25 years were recruited between February 2013 and October 2015 as part of a larger Australia-wide study. This study analyzed data collected through a semistructured telephone interview. Interviews were recorded and transcribed verbatim and then coded line-by-line. Data were analyzed for emergent themes using the qualitative software NVivo. RESULTS Many participants demonstrated a good understanding of their cancer diagnosis and treatment. Participants expressed high levels of confidence in their healthcare teams and demonstrated a conscientious approach to their ongoing cancer-specific and general healthcare. However, most AYAs had expectations of the cancer journey that differed from the realities of their experiences. CONCLUSIONS The results further highlight the crucial role of healthcare professionals in ensuring AYA cancer patients have accurate expectations of diagnosis and treatment, and develop a strong working knowledge of their disease that is maintained into survivorship. AYA cancer survivors may require ongoing education and support to stay engaged with long-term follow-up care.
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Affiliation(s)
- Elizabeth A May
- 1 Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, New South Wales, Australia .,2 Behavioural Sciences Unit proudly supported by the Kids with Cancer Foundation, Kids Cancer Centre, Sydney Children's Hospital , Randwick, New South Wales, Australia
| | - Brittany C McGill
- 1 Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, New South Wales, Australia .,2 Behavioural Sciences Unit proudly supported by the Kids with Cancer Foundation, Kids Cancer Centre, Sydney Children's Hospital , Randwick, New South Wales, Australia
| | - Eden G Robertson
- 1 Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, New South Wales, Australia .,2 Behavioural Sciences Unit proudly supported by the Kids with Cancer Foundation, Kids Cancer Centre, Sydney Children's Hospital , Randwick, New South Wales, Australia
| | - Antoinette Anazodo
- 3 Sydney Youth Cancer Service, Sydney Children's and Prince of Wales Hospitals , Sydney, New South Wales, Australia
| | - Claire E Wakefield
- 1 Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, New South Wales, Australia .,2 Behavioural Sciences Unit proudly supported by the Kids with Cancer Foundation, Kids Cancer Centre, Sydney Children's Hospital , Randwick, New South Wales, Australia
| | - Ursula M Sansom-Daly
- 1 Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, New South Wales, Australia .,2 Behavioural Sciences Unit proudly supported by the Kids with Cancer Foundation, Kids Cancer Centre, Sydney Children's Hospital , Randwick, New South Wales, Australia .,3 Sydney Youth Cancer Service, Sydney Children's and Prince of Wales Hospitals , Sydney, New South Wales, Australia
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177
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Georgakis MK, Papathoma P, Ryzhov A, Zivkovic-Perisic S, Eser S, Taraszkiewicz Ł, Sekerija M, Žagar T, Antunes L, Zborovskaya A, Bastos J, Florea M, Coza D, Demetriou A, Agius D, Strahinja RM, Themistocleous M, Tolia M, Tzanis S, Alexiou GA, Papanikolaou PG, Nomikos P, Kantzanou M, Dessypris N, Pourtsidis A, Petridou ET. Malignant central nervous system tumors among adolescents and young adults (15-39 years old) in 14 Southern-Eastern European registries and the US Surveillance, Epidemiology, and End Results program: Mortality and survival patterns. Cancer 2017; 123:4458-4471. [DOI: 10.1002/cncr.30884] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/09/2017] [Accepted: 06/23/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Marios K. Georgakis
- Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - Paraskevi Papathoma
- Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine; National and Kapodistrian University of Athens; Athens Greece
- Department of Neurology; University Hospital; Linköping Sweden
| | - Anton Ryzhov
- National Cancer Registry of Ukraine; National Institute of Cancer; Kiev Ukraine
| | | | - Sultan Eser
- Izmir Cancer Registry, Izmir Hub; Izmir and Hacettepe University Institute of Public Health; Ankara Turkey
| | - Łukasz Taraszkiewicz
- Greater Poland Cancer Registry, Department of Cancer Prevention and Epidemiology; Greater Poland Cancer Center; Poznan Poland
| | - Mario Sekerija
- Croatian National Cancer Registry; Croatian Institute of Public Health; Zagreb Croatia
| | - Tina Žagar
- Cancer Registry of the Republic of Slovenia; Institute of Oncology; Ljubljana Slovenia
| | - Luis Antunes
- North Region Cancer Registry of Portugal; Portuguese Oncology Institute of Porto; Porto Portugal
| | - Anna Zborovskaya
- Belarusian Research Center for Pediatric Oncology, Hematology, and Immunology; Childhood Cancer Subregistry of Belarus; Minsk Belarus
| | - Joana Bastos
- Central Region Cancer Registry of Portugal; Portuguese Oncology Institute of Coimbra; Coimbra Portugal
| | - Margareta Florea
- Regional Cancer Registry of Iasi; National Institute of Public Health; Iasi Romania
| | - Daniela Coza
- Regional Cancer Registry of Cluj; Ion Chiricuta Oncological Institute; Cluj-Napoca Romania
| | - Anna Demetriou
- Cyprus Cancer Registry, Health Monitoring Unit; Ministry of Health; Nicosia Cyprus
| | - Domenic Agius
- Malta National Cancer Registry, Department of Health Information and Research; Valletta Malta
| | - Rajko M. Strahinja
- Cancer Registry, Department for Epidemiology of Noncommunicable Diseases, Center for Disease Prevention and Control; Institute of Public Health; Podgorica Montenegro
| | | | - Maria Tolia
- Second Department of Radiology, Radiotherapy Unit, Attikon University Hospital, School of Medicine; National and Kapodistrian University of Athens; Greece Athens
| | - Spyridon Tzanis
- Neurosurgery Department; Errikos Dunant Hospital Center; Athens Greece
| | - George A. Alexiou
- Neurosurgical Institute; Ioannina University School of Medicine; Ioannina Greece
| | | | - Panagiotis Nomikos
- Department of Neurosurgery and Gamma Knife Radiosurgery; Hygeia Hospital; Athens Greece
| | - Maria Kantzanou
- Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - Nick Dessypris
- Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - Apostolos Pourtsidis
- Department of Pediatric Hematology and Oncology; Panagiotis and Aglaia Kyriakou Children's Hospital; Athens Greece
| | - Eleni T. Petridou
- Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine; National and Kapodistrian University of Athens; Athens Greece
- Clinical Epidemiology Unit, Department of Medicine; Karolinska Institute; Stockholm Sweden
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178
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Ferrari A, Trama A, De Paoli A, Bergeron C, Merks JHM, Jenney M, Orbach D, Chisholm JC, Gallego S, Glosli H, De Salvo GL, Botta L, Gatta G, Bisogno G. Access to clinical trials for adolescents with soft tissue sarcomas: Enrollment in European pediatric Soft tissue sarcoma Study Group (EpSSG) protocols. Pediatr Blood Cancer 2017; 64. [PMID: 27882658 DOI: 10.1002/pbc.26348] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/28/2016] [Accepted: 10/12/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND Adolescents with cancer are enrolled in clinical trials at far lower rates than children. This report compares the number of adolescents (15-19-year-olds) and children (0-14-year-olds) enrolled in the protocols of the European pediatric Soft tissue sarcoma Study Group (EpSSG) with the number of cases expected to occur. METHODS The observed-to-expected (O/E) ratio was detected in the EpSSG countries contributing most of the cases, that is, Italy, France, Spain, the Netherlands, United Kingdom, and Ireland. The observed cases included patients enrolled in any of the EpSSG protocols from October 2008 to October 2015, when all EpSSG protocols were open in these countries. The number of expected cases was calculated from the incidence rates estimated throughout the RARECAREnet database in the countries' population-based cancer registries. RESULTS In the countries considered, 2,118 cases aged 0-19 years were enrolled in the EpSSG trials from 2008 to 2015: 82.8% were children and 17.2% were adolescents. The O/E ratio was 0.30 among patients 15-19 years old, as opposed to 0.64 for those 0-14 years old. The O/E ratio differed for the different subtypes: in adolescents, it was 0.64 and 0.18 for rhabdomyosarcoma (RMS) and non-rhabdomyosarcoma soft tissue sarcomas (NRSTS), respectively; in children, it was 0.77 and 0.50, respectively. The O/E ratios differed across the countries considered. CONCLUSIONS Adolescents were less well represented than children on the EpSSG protocols, with better enrolment for RMS than for NRSTS for all age groups.
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Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Annalisa Trama
- Department of Preventive and Predictive Medicine, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Angela De Paoli
- Clinical Trials and Biostatistics Unit, IRCCS Istituto Oncologico Veneto, Padova, Italy
| | - Christophe Bergeron
- Department of Pediatric Oncology, Institut d'Hematologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Johannes H M Merks
- Department of Pediatric Oncology, Emma Children's Hospital-Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Meriel Jenney
- Department of Pediatric Oncology, Children's Hospital for Wales, Heath Park, Cardiff, United Kingdom
| | - Daniel Orbach
- Department of Pediatric, Adolescent and Young Adult Oncology, Institut Curie, Paris, France
| | - Julia C Chisholm
- Department of Paediatric Oncology, Royal Marsden Hospital, London, United Kingdom
| | - Soledad Gallego
- Department of Paediatric Oncology, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Heidi Glosli
- Department of Pediatrics, University Hospital Oslo, Rikshospitalet, Oslo, Norway
| | - Gian Luca De Salvo
- Clinical Trials and Biostatistics Unit, IRCCS Istituto Oncologico Veneto, Padova, Italy
| | - Laura Botta
- Department of Preventive and Predictive Medicine, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Gemma Gatta
- Department of Preventive and Predictive Medicine, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Gianni Bisogno
- Pediatric Hematology and Oncology Division, Padova University, Padova, Italy
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179
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Boissel N, Ducassou S. [Adolescents and young adults with acute lymphoblastic leukemia. A specific management]. Bull Cancer 2017; 104:683-689. [PMID: 28576259 DOI: 10.1016/j.bulcan.2017.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/28/2017] [Accepted: 03/02/2017] [Indexed: 01/05/2023]
Abstract
The acute lymphoblastic leukemia (ALL) is one of the first cancer for which emerged the particularity of the adolescent and young adult population. After decades of poorly concerted approaches, adult and pediatric haematologists found out that adolescents treated according to pediatric approaches had a better outcome than those treated in adult protocols. Therefore, pediatric-inspired therapies have been successfully implemented in the young adult population, leading to decreased criteria for allogeneic stem cell transplantation. More recently, a high prevalence of Philadelphia-like ALL has been identified in the AYA population, which opens the door to the combination of target therapy similar to Philadelphia-positive ALL. AYA patients require specific care programs including fertility counselling, adhesion evaluation, and long-term survivor follow-up. They are to be optimally treated by multidisciplinary teams, exploring their personal needs and determining the best management of the "whole patient".
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Affiliation(s)
- Nicolas Boissel
- Hôpital Saint-Louis, unité d'hématologie adolescents et jeunes adultes, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - Stéphane Ducassou
- Hôpital des enfants, unité d'hématologie et oncologie pédiatrique, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
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180
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Davis LE, Janeway KA, Weiss AR, Chen YLE, Scharschmidt TJ, Krailo M, Glade Bender JL, Kopp LM, Patel SR, Schwartz GK, Horvath LE, Hawkins DS, Chuk MK, Reinke DK, Gorlick RG, Randall RL. Clinical trial enrollment of adolescents and young adults with sarcoma. Cancer 2017; 123:3434-3440. [PMID: 28493547 DOI: 10.1002/cncr.30757] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 03/14/2017] [Accepted: 04/05/2017] [Indexed: 11/12/2022]
Abstract
More than half of all sarcomas occur in adolescents and young adults (AYAs) aged 15 to 39 years. After the publication of the AYA series in the April 1, 2016 issue of Cancer, several leaders in the field of sarcoma across disciplines gathered to discuss the status of sarcoma clinical research in AYAs. They determined that a focused effort to include the underrepresented and understudied AYA population in current and future sarcoma clinical trials is overdue. Trial enrichment for AYA-aged sarcoma patients will produce more meaningful results that better represent the disease's biology, epidemiology, and treatment environment. To address the current deficit, this commentary outlines changes believed to be necessary to expediently achieve an increase in the enrollment of AYAs in sarcoma clinical trials. Cancer 2017;123:3434-40. © 2017 American Cancer Society.
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Affiliation(s)
- Lara E Davis
- Knight Cancer Institute, Department of Medicine and Department of Pediatrics, Oregon Health and Science University, Portland, Oregon
| | - Katherine A Janeway
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts
| | | | - Yen-Lin E Chen
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Mark Krailo
- Department of Preventative Medicine, University of Southern California, Los Angeles, California
| | - Julia L Glade Bender
- Department of Pediatrics, Columbia University Medical Center, New York, New York
| | - Lisa M Kopp
- Department of Pediatrics, University of Arizona Cancer Center, Tucson, Arizona
| | - Shreyaskumar R Patel
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gary K Schwartz
- Department of Medicine, Columbia University Medical Center, New York, New York
| | | | - Douglas S Hawkins
- Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | | | - Denise K Reinke
- Sarcoma Alliance for Research Through Collaboration, Ann Arbor, Michigan
| | - Richard G Gorlick
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - R Lor Randall
- Department of Orthopedics, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
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181
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Bright CJ, Hawkins MM, Guha J, Henson KE, Winter DL, Kelly JS, Feltbower RG, Hall M, Cutter DJ, Edgar AB, Frobisher C, Reulen RC. Risk of Cerebrovascular Events in 178 962 Five-Year Survivors of Cancer Diagnosed at 15 to 39 Years of Age: The TYACSS (Teenage and Young Adult Cancer Survivor Study). Circulation 2017; 135:1194-1210. [PMID: 28122884 PMCID: PMC7614827 DOI: 10.1161/circulationaha.116.025778] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 01/17/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND Survivors of teenage and young adult cancer are at risk of cerebrovascular events, but the magnitude of and extent to which this risk varies by cancer type, decade of diagnosis, age at diagnosis, and attained age remains uncertain. This is the largest-ever cohort study to evaluate the risks of hospitalization for a cerebrovascular event among long-term survivors of teenage and young adult cancer. METHODS The population-based TYACSS (Teenage and Young Adult Cancer Survivor Study) (N=178,962) was linked to Hospital Episode Statistics data for England to investigate the risks of hospitalization for a cerebrovascular event among 5-year survivors of cancer diagnosed when 15 to 39 years of age. Observed numbers of first hospitalizations for cerebrovascular events were compared with that expected from the general population using standardized hospitalization ratios (SHRs) and absolute excess risks per 10 000 person-years. Cumulative incidence was calculated with death considered a competing risk. RESULTS Overall, 2782 cancer survivors were hospitalized for a cerebrovascular event-40% higher than expected (SHR=1.4, 95% confidence interval, 1.3-1.4). Survivors of central nervous system (CNS) tumors (SHR=4.6, 95% confidence interval, 4.3-5.0), head and neck tumors (SHR=2.6, 95% confidence interval, 2.2-3.1), and leukemia (SHR=2.5, 95% confidence interval, 1.9-3.1) were at greatest risk. Males had significantly higher absolute excess risks than females (absolute excess risks =7 versus 3), especially among head and neck tumor survivors (absolute excess risks =30 versus 11). By 60 years of age, 9%, 6%, and 5% of CNS tumor, head and neck tumor, and leukemia survivors, respectively, had been hospitalized for a cerebrovascular event. Beyond 60 years of age, every year, 0.4% of CNS tumor survivors were hospitalized for a cerebral infarction (versus 0.1% expected), whereas at any age, every year, 0.2% of head and neck tumor survivors were hospitalized for a cerebral infarction (versus 0.06% expected). CONCLUSIONS Survivors of a CNS tumor, head and neck tumor, and leukemia are particularly at risk of hospitalization for a cerebrovascular event. The excess risk of cerebral infarction among CNS tumor survivors increases with attained age. For head and neck tumor survivors, this excess risk remains high across all ages. These groups of survivors, particularly males, should be considered for surveillance of cerebrovascular risk factors and potential pharmacological interventions for cerebral infarction prevention.
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Affiliation(s)
- Chloe J Bright
- From Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Science, University of Birmingham, UK (C.J.B., M.M.H., J.G., D.L.W., J.S.K., C.F., R.C.R.); Public Health England, Birmingham, UK (J.G.); Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK (K.E.H., D.J.C.); Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, UK (R.G.F., M.H.); and Royal Hospital for Sick Children, Edinburgh, UK (A.B.E.)
| | - Mike M Hawkins
- From Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Science, University of Birmingham, UK (C.J.B., M.M.H., J.G., D.L.W., J.S.K., C.F., R.C.R.); Public Health England, Birmingham, UK (J.G.); Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK (K.E.H., D.J.C.); Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, UK (R.G.F., M.H.); and Royal Hospital for Sick Children, Edinburgh, UK (A.B.E.)
| | - Joyeeta Guha
- From Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Science, University of Birmingham, UK (C.J.B., M.M.H., J.G., D.L.W., J.S.K., C.F., R.C.R.); Public Health England, Birmingham, UK (J.G.); Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK (K.E.H., D.J.C.); Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, UK (R.G.F., M.H.); and Royal Hospital for Sick Children, Edinburgh, UK (A.B.E.)
| | - Katherine E Henson
- From Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Science, University of Birmingham, UK (C.J.B., M.M.H., J.G., D.L.W., J.S.K., C.F., R.C.R.); Public Health England, Birmingham, UK (J.G.); Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK (K.E.H., D.J.C.); Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, UK (R.G.F., M.H.); and Royal Hospital for Sick Children, Edinburgh, UK (A.B.E.)
| | - David L Winter
- From Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Science, University of Birmingham, UK (C.J.B., M.M.H., J.G., D.L.W., J.S.K., C.F., R.C.R.); Public Health England, Birmingham, UK (J.G.); Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK (K.E.H., D.J.C.); Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, UK (R.G.F., M.H.); and Royal Hospital for Sick Children, Edinburgh, UK (A.B.E.)
| | - Julie S Kelly
- From Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Science, University of Birmingham, UK (C.J.B., M.M.H., J.G., D.L.W., J.S.K., C.F., R.C.R.); Public Health England, Birmingham, UK (J.G.); Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK (K.E.H., D.J.C.); Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, UK (R.G.F., M.H.); and Royal Hospital for Sick Children, Edinburgh, UK (A.B.E.)
| | - Richard G Feltbower
- From Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Science, University of Birmingham, UK (C.J.B., M.M.H., J.G., D.L.W., J.S.K., C.F., R.C.R.); Public Health England, Birmingham, UK (J.G.); Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK (K.E.H., D.J.C.); Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, UK (R.G.F., M.H.); and Royal Hospital for Sick Children, Edinburgh, UK (A.B.E.)
| | - Marlous Hall
- From Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Science, University of Birmingham, UK (C.J.B., M.M.H., J.G., D.L.W., J.S.K., C.F., R.C.R.); Public Health England, Birmingham, UK (J.G.); Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK (K.E.H., D.J.C.); Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, UK (R.G.F., M.H.); and Royal Hospital for Sick Children, Edinburgh, UK (A.B.E.)
| | - David J Cutter
- From Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Science, University of Birmingham, UK (C.J.B., M.M.H., J.G., D.L.W., J.S.K., C.F., R.C.R.); Public Health England, Birmingham, UK (J.G.); Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK (K.E.H., D.J.C.); Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, UK (R.G.F., M.H.); and Royal Hospital for Sick Children, Edinburgh, UK (A.B.E.)
| | - Angela B Edgar
- From Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Science, University of Birmingham, UK (C.J.B., M.M.H., J.G., D.L.W., J.S.K., C.F., R.C.R.); Public Health England, Birmingham, UK (J.G.); Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK (K.E.H., D.J.C.); Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, UK (R.G.F., M.H.); and Royal Hospital for Sick Children, Edinburgh, UK (A.B.E.)
| | - Clare Frobisher
- From Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Science, University of Birmingham, UK (C.J.B., M.M.H., J.G., D.L.W., J.S.K., C.F., R.C.R.); Public Health England, Birmingham, UK (J.G.); Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK (K.E.H., D.J.C.); Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, UK (R.G.F., M.H.); and Royal Hospital for Sick Children, Edinburgh, UK (A.B.E.)
| | - Raoul C Reulen
- From Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Science, University of Birmingham, UK (C.J.B., M.M.H., J.G., D.L.W., J.S.K., C.F., R.C.R.); Public Health England, Birmingham, UK (J.G.); Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK (K.E.H., D.J.C.); Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, UK (R.G.F., M.H.); and Royal Hospital for Sick Children, Edinburgh, UK (A.B.E.).
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182
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Fairley L, Stark DP, Yeomanson D, Kinsey SE, Glaser AW, Picton SV, Evans L, Feltbower RG. Access to principal treatment centres and survival rates for children and young people with cancer in Yorkshire, UK. BMC Cancer 2017; 17:168. [PMID: 28257637 PMCID: PMC5336656 DOI: 10.1186/s12885-017-3160-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 03/01/2017] [Indexed: 11/10/2022] Open
Abstract
Background Principal Treatment Centres (PTC) were established to provide age-appropriate care as well as clinical expertise for children and young people with cancer. However, little is known about the effects of specialist treatment centres on survival outcomes especially for teenagers and young adults. This population-based study aimed to describe access to PTC and the associated trends in survival for 0–24 year olds accounting for stage of disease at presentation and treatment. Methods Patients diagnosed from 1998–2009 aged 0–24 years were extracted from the Yorkshire Specialist Register of Cancer in Children and Young People, including information on all treating hospitals, followed-up until 31st December 2014. The six commonest cancer types were included: leukaemia (n = 684), lymphoma (n = 558), CNS tumours (n = 547), germ cell tumours (n = 364), soft tissue sarcomas (n = 171) and bone tumours (n = 163). Treatment was categorised into three groups: ‘all’, ‘some’ or ‘no’ treatment received at a PTC. Treatment at PTC was examined by diagnostic group and patient characteristics. Overall survival was modelled using Cox regression adjusting for case-mix including stage, treatment and other socio-demographic and clinical characteristics. Results Overall 72% of patients received all their treatment at PTC whilst 13% had no treatment at PTC. This differed by diagnostic group and age at diagnosis. Leukaemia patients who received no treatment at PTC had an increased risk of death which was partially explained by differences in patient case-mix (adjusted Hazard Ratio (HR) = 1.73 (95%CI 0.98–3.04)). Soft tissue sarcoma patients who had some or no treatment at PTC had better survival outcomes, which remained after adjustment for patient case-mix (adjusted HR = 0.48 (95%CI 0.23–0.99)). There were no significant differences in outcomes for other diagnostic groups (lymphoma, CNS tumours, bone tumours and germ cell tumours). For leukaemia patients survival outcomes for low risk patients receiving no treatment at PTC were similar to high risk patients who received all treatment at PTC, implying a benefit for care at the PTC. Conclusion This study demonstrates that for leukaemia patients receiving treatment at a PTC is associated with improved survival that may compensate for a poorer prognosis presentation. However, further information on risk factors is needed for all diagnostic groups in order to fully account for differences in patient case-mix. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3160-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lesley Fairley
- Division of Epidemiology and Biostatistics, School of Medicine, Worsley Building, University of Leeds, Clarendon Way, Leeds, UK, LS2 9JT.
| | - Daniel P Stark
- St James's Institute of Oncology, Leeds Institute of Cancer and Pathology, University of Leeds and Leeds Teaching Hospitals NHS Trust, Bexley Wing, St James's Hospital, Beckett Street, Leeds, LS9 7TF, UK
| | - Daniel Yeomanson
- Paediatric Oncology and Haematology Department, Sheffield Children's Hospital, Western Bank, Sheffield, S10 2TH, UK
| | - Sally E Kinsey
- St James's Institute of Oncology, Leeds Institute of Cancer and Pathology, University of Leeds and Leeds Teaching Hospitals NHS Trust, Bexley Wing, St James's Hospital, Beckett Street, Leeds, LS9 7TF, UK.,Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK
| | - Adam W Glaser
- St James's Institute of Oncology, Leeds Institute of Cancer and Pathology, University of Leeds and Leeds Teaching Hospitals NHS Trust, Bexley Wing, St James's Hospital, Beckett Street, Leeds, LS9 7TF, UK
| | - Susan V Picton
- Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK
| | - Linda Evans
- Sheffield Teaching Hospitals NHS Foundation Trust, Weston Park Hospital, Whitham Road, Sheffield, S10 2SJ, UK
| | - Richard G Feltbower
- Division of Epidemiology and Biostatistics, School of Medicine, Worsley Building, University of Leeds, Clarendon Way, Leeds, UK, LS2 9JT
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183
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van der Graaf WTA, Orbach D, Judson IR, Ferrari A. Soft tissue sarcomas in adolescents and young adults: a comparison with their paediatric and adult counterparts. Lancet Oncol 2017; 18:e166-e175. [PMID: 28271871 DOI: 10.1016/s1470-2045(17)30099-2] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 11/07/2016] [Accepted: 11/10/2016] [Indexed: 10/20/2022]
Abstract
Survival outcomes for adolescent and young adult patients with soft tissue sarcomas lag behind those of children diagnosed with histologically similar tumours. To help understand these differences in outcomes, we discuss the following issues with regard to the management of these patients with soft tissue sarcomas: delays in diagnosis, trial availability and participation, aspects of the organisation of care (with an emphasis on age-specific needs), national centralisation of sarcoma care, international consortia, and factors related to tumour biology. Improved understanding of the causes of the survival gap between adolescents and young adults with sarcomas will help drive new initiatives to improve final health outcomes in these populations. In this Review, we specifically focus on embryonal and alveolar rhabdomyosarcoma, synovial sarcoma, and adult soft tissue sarcomas diagnosed in adolescents and young adults, and discuss the age-specific needs of these patients.
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Affiliation(s)
- Winette T A van der Graaf
- Division of Clinical Studies, Institute of Cancer Research, London, UK; Sarcoma Unit of the Royal Marsden NHS Foundation Trust, London, UK; Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Daniel Orbach
- Pediatric, Adolescent and Young Adult Oncology Department, Institut Curie, Paris, France
| | - Ian R Judson
- Division of Clinical Studies, Institute of Cancer Research, London, UK; Sarcoma Unit of the Royal Marsden NHS Foundation Trust, London, UK
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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184
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Dumas A, Allodji R, Fresneau B, Valteau-Couanet D, El-Fayech C, Pacquement H, Laprie A, Nguyen TD, Bondiau PY, Diallo I, Guibout C, Rubino C, Haddy N, Oberlin O, Vassal G, de Vathaire F. The right to be forgotten: a change in access to insurance and loans after childhood cancer? J Cancer Surviv 2017; 11:431-437. [PMID: 28130711 DOI: 10.1007/s11764-017-0600-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/17/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE Access to insurance for a loan or a mortgage is an important issue for childhood cancer survivors. The aim of this study was to describe difficulties experienced by adult survivors. METHODS A total of 1920 survivors treated before the age of 18 in five French cancer centers responded to a questionnaire in 2010. Survivors who had tried to obtain a loan were asked if they had experienced difficulties, which were defined as experiencing rejection, higher premiums, or exclusions. The questionnaire investigated health problems related to the circulatory, respiratory, digestive, urinary, endocrine, hormonal, and nervous systems. Second tumors, diabetes mellitus, cardiac disease, and stroke were ascertained from a physician's report or medical records. Multivariable analyses were conducted to identify the characteristics of survivors reporting difficulties. RESULTS Difficulties were experienced by 10.4% of those who had tried to obtain a small loan (n = 787) and by 30.1% of those who had tried to obtain a home loan (n = 909). Disclosure of childhood cancer to the insurer and amputation surgery were negatively associated with insurance accessibility, even when controlling for age, gender, education, health-related unemployment, familial situation, and severe or life-threatening conditions such as cardiovascular diseases, second cancers, or diabetes. CONCLUSION This study showed that the financial burden of cancer can extend decades after diagnosis. IMPLICATIONS FOR CANCER SURVIVORS Thanks to a 2016 law, French cancer survivors no longer have to disclose their cancer to insurers after a fixed number of years. This law will probably lessen the socioeconomic burden of cancer.
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Affiliation(s)
- Agnès Dumas
- Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France. .,Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France.
| | - Rodrigue Allodji
- Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.,Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France
| | - Brice Fresneau
- Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.,Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France.,Department of Paediatric and Adolescent Oncology, Gustave Roussy, 94805, Villejuif, France
| | | | - Chiraz El-Fayech
- Department of Paediatric and Adolescent Oncology, Gustave Roussy, 94805, Villejuif, France
| | - Hélène Pacquement
- Department of Paediatric Oncology, Institut Curie, 75005, Paris, France
| | - Anne Laprie
- Department of Radiation Oncology, Centre Claudius Regaud, 31059, Toulouse, France
| | - Tan Dat Nguyen
- Radiotherapy Department, Centre Jean Godinot, 51100, Reims, France
| | - Pierre-Yves Bondiau
- Department of Radiation Oncology, Centre Antoine Lacassagne, 06100, Nice, France
| | - Ibrahima Diallo
- Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.,Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France
| | - Catherine Guibout
- Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.,Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France
| | - Carole Rubino
- Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.,Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France
| | - Nadia Haddy
- Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.,Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France
| | - Odile Oberlin
- Department of Paediatric and Adolescent Oncology, Gustave Roussy, 94805, Villejuif, France
| | - Gilles Vassal
- Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France
| | - Florent de Vathaire
- Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.,Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France
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185
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Ries L, Trama A, Nakata K, Gatta G, Botta L, Bleyer A. Cancer Incidence, Survival, and Mortality Among Adolescents and Young Adults. CANCER IN ADOLESCENTS AND YOUNG ADULTS 2017. [DOI: 10.1007/978-3-319-33679-4_2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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186
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Ferrari A, Silva M, Veneroni L, Magni C, Clerici CA, Meazza C, Terenziani M, Spreafico F, Chiaravalli S, Casanova M, Luksch R, Catania S, Schiavello E, Biassoni V, Podda M, Bergamaschi L, Puma N, Indini A, Proserpio T, Massimino M. Measuring the efficacy of a project for adolescents and young adults with cancer: A study from the Milan Youth Project. Pediatr Blood Cancer 2016; 63:2197-2204. [PMID: 27554940 DOI: 10.1002/pbc.26172] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/08/2016] [Accepted: 06/28/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Various projects dedicated specifically to adolescents and young adults (AYA) with cancer have been developed in recent years. A critical aspect of such programs is the ability to demonstrate its value, and therefore how to measure desired outcomes. METHODS A list of metrics to consider for demonstrating the advantages of an AYA program was identified and used to assess the activity of the Youth Project operating at the Pediatric Oncology Unit of the Istituto Nazionale Tumori in Milan. RESULTS The number of newly diagnosed AYA patients seen at the Unit has increased since the formal launch of the Youth Project, from 65 to 81.2 cases/year. Concerning the 78 AYA patients presenting with malignant neoplasms in 2015, 82% were included in clinical trials (the other 18% in prospective observational studies). Fertility preservation measures were implemented for 59% of AYA patients considered at risk, and specific psychological support was provided in 70.6% of cases; 72.5% of patients actively participated in support activities. Other parameters considered were a preliminary satisfaction questionnaire administered to patients and the program's scientific recognition and acknowledgment by the community. CONCLUSIONS The study proposed a number of potentially reproducible, practical parameters to consider in assessing the value of a program dedicated to AYA. These metrics were examined in terms of the activities of our Youth Project, and confirmed its efficacy. To be sustainable over time, AYA projects have to be accepted as a standard of care at the community and government levels.
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Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy.
| | - Matteo Silva
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Laura Veneroni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Chiara Magni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Carlo Alfredo Clerici
- Clinical Biology, Oncology and Hemato-Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Cristina Meazza
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Monica Terenziani
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Filippo Spreafico
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Stefano Chiaravalli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Roberto Luksch
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Serena Catania
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Elisabetta Schiavello
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Veronica Biassoni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Marta Podda
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Luca Bergamaschi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Nadia Puma
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Alice Indini
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Tullio Proserpio
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Lombardia, Italy
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187
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Corradini N, Dagorne L, Retailleau M, Rédini F, Sudour-Bonnange H, Gofti-Laroche L, Le Rhun A, Gaspar N. [Which approach of therapeutic education (TE) for adolescents and young adults with cancer? Experience from the TE working group of "Go-AJA"]. Bull Cancer 2016; 103:966-978. [PMID: 27863724 DOI: 10.1016/j.bulcan.2016.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/03/2016] [Accepted: 10/06/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Therapeutic education (TE) is a practice developed over 40 years at an international level to give people with chronic illness the skills necessary to help them better manage their disease. The lengthening survival time of cancer patients as well as changes in the patient-caregiver relationship have contributed to the development of TE in oncologic diseases. Every year in France, about 1900 adolescents and young adults (15-25 years old) are diagnosed with cancer which is the second leading cause of death in this age group. The observed survival rates for these patients are lower when compared with children's. Some of the hypotheses put forward to explain this difference include a lack of constancy in care and a non-following treatment, as failure to adhere to therapies is common in this age group. "Go-AJA", an interdisciplinary national organization established in 2012, aims to improve the quality of care and treatment results for AYA living with cancer. Therapeutic education for AYA in oncology is an active working group of "Go-AJA" and intends to draw recommendations and to improve adapted communication on different education topics. Elaboration and preparation of TE programs by skilled multidisciplinary teams engaged in interactive educational actions is the first and most crucial step. MATERIALS AND METHODS The TE "Go-AJA" working group has federated pediatric and adult oncologists, nurses, psychologists, TE professionals, and resource patients, thanks to the commitment of professionals from the 8 national teams supported by the National Cancer Institute. Physical meetings and conference calls were organized from 2012 to 2015 to construct TE tools and programs for AYA with cancer. RESULTS A competence referential was built and adapted to AYA population with cancer, after focused groups organized in 2 main oncology centers with on-therapy sarcoma patients and members of the multidisciplinary TE working group. Tools were validated and adapted to adolescents or young adults with cancer, to help in the 4 stages of TE: the "educational diagnosis" allowing the caregiver to better understand the patient in his life journey with the disease; the "therapeutic alliance" allowing to agree with the patient on his/her priorities; the "implementation" which is an action step: information, awareness, learning and psychosocial support. The final step called "assessment" allows the caregiver to take stock on the changes and difficulties with the patient. TE for AYA with cancer included individual and/or group sessions to improve self-care skills: knowledge about the disease (group sessions "what is cancer?" with use of microscopes to visualize sarcoma cells, and guided tours in a tumor research laboratory), and details about the treatment and its consequences (workshops about "management of febrile neutropenia"). Moreover, TE aimed to enrich the field of coping skills, in particular to improve the coordination and experience of cares between the different complex and varied network of care (group and/or individual sessions focused on physical rehabilitation, and adapted school/professional orientation). CONCLUSION Regardless of the care system, care workers dedicated to AYA with cancer should use TE-specific actions to reinforce treatment participation and therapeutic relationships. This active multidisciplinary TE working group dedicated to AYA with cancer elaborated TE programs by skilled multidisciplinary teams engaged in interactive educational actions. After this work of a national TE organization, more studies using methodological tools are still required to evaluate the impact of such implemented programs on the treatment results and the quality of life.
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Affiliation(s)
- Nadège Corradini
- Institut d'hémato-oncologie pédiatrique, centre Léon-Bérard, dispositif AJA en cancérologie, 28, prom. Léa-et-Napoléon-Bullukian, 69008 Lyon, France.
| | - Loïc Dagorne
- Cancer campus Gustave-Roussy, département de cancérologie de l'enfant et l'adolescent, équipe transversale SPIAJA, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| | - Marielle Retailleau
- CHU de Nantes, hôpital mère-enfant, département d'oncologie pédiatrique, quai Moncousu, 44093 Nantes cedex 1, France
| | - Françoise Rédini
- Faculté de médecine, Inserm UMR957, « laboratoire de PHysiopathologie de la résorption osseuse et thérapie des tumeurs osseuses primitives », 1, rue Gaston Veil, 44035 Nantes cedex 1, France
| | - Hélène Sudour-Bonnange
- Centre Oscar-Lambret, unité d'oncologie pédiatrique, équip'AJA, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - Leila Gofti-Laroche
- CHU Grenoble Alpes, hôpital couple enfant, équipe AJA Arc Alpin, avenue Maquis-du-Grésivaudan, 38700 La Tronche, France
| | - Anne Le Rhun
- CHU, hôpital Saint-Jacques, département de santé publique, unité d'éducation thérapeutique, bâtiment Louis-Philippe, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France
| | - Nathalie Gaspar
- Cancer campus Gustave-Roussy, département de cancérologie de l'enfant et l'adolescent, équipe transversale SPIAJA, 114, rue Edouard-Vaillant, 94800 Villejuif, France
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188
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Marec-Bérard P, Boissel N. [Teenagers and young adults facing cancer: Specific issues]. Bull Cancer 2016; 103:955-956. [PMID: 27817862 DOI: 10.1016/j.bulcan.2016.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 09/30/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Perrine Marec-Bérard
- Groupe d'oncohématologie adolescents et jeunes adultes, 75010 Paris, France; Centre de lutte contre le cancer Léon-Bérard, 69008 Lyon, France.
| | - Nicolas Boissel
- Groupe d'oncohématologie adolescents et jeunes adultes, 75010 Paris, France; AP-HP, université Paris 7, hôpital Saint-Louis, EA-3518, 75010 Paris, France
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189
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Age at cancer diagnosis and interpretation of survival statistics. Lancet Oncol 2016; 17:847-848. [PMID: 27237615 DOI: 10.1016/s1470-2045(16)30048-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 03/29/2016] [Indexed: 11/23/2022]
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