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Ferrari A, Perillo T, Milano GM, Silva M, Rutigliano C, Salvo A, Livellara V, Conte M, Coccoli L, Amore E, Pierobon M, Vietina F, Pagani Bagliacca E, Spinelli M, Massei MS, Massetti V, Legnani E, Puglisi I, Zucchetti G, Quarello P. The power of art and the powers of adolescents with cancer: Age-specific projects at Italian pediatric oncology centers. TUMORI JOURNAL 2024; 110:218-226. [PMID: 38591573 DOI: 10.1177/03008916241245005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
This article describes the oncology programs developed in Italy for adolescents and young adults with cancer, with a specific focus on the local projects created in pediatric oncology centers. A common feature of such projects is the emphasis on creative and artistic activities and laboratories (involving music, photography, novel writing, fashion design, and so on) designed to give young patients innovative means of expression.This article highlights the amazing powers of adolescents involved in these projects: the power to produce beautiful things in a place that is not normally associated with the idea of beauty; the power to make their doctors smile and grasp the profound sense of life; the power to make hospitals become places for producing culture.
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Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Teresa Perillo
- Pediatric Hematology-Oncology Division, Department of Pediatrics, University of Bari, Bari, Italy
| | | | - Matteo Silva
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Chiara Rutigliano
- Pediatric Hematology-Oncology Division, Department of Pediatrics, University of Bari, Bari, Italy
| | - Andrea Salvo
- Hematology/Oncology, Ospedale Pediatrico Bambino Gesù IRCCS, Roma, Italy
| | - Virginia Livellara
- Department of Pediatric Hematology/Oncology, Giannina Gaslini Children's Hospital, Genoa, Italy
| | - Massimo Conte
- Department of Pediatric Hematology/Oncology, Giannina Gaslini Children's Hospital, Genoa, Italy
| | - Luca Coccoli
- Pediatric Hematology-Oncology Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Elena Amore
- Pediatric Hematology-Oncology Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Marta Pierobon
- Pediatric Hematology Oncology Division, University of Padua, Padua, Italy
| | - Francesco Vietina
- Pediatric Hematology Oncology Division, University of Padua, Padua, Italy
| | - Elena Pagani Bagliacca
- Pediatric Hematology-Oncology Department, Fondazione MBBM, Ospedale San Gerardo, Monza, Italy
| | - Marco Spinelli
- Pediatric Hematology-Oncology Department, Fondazione MBBM, Ospedale San Gerardo, Monza, Italy
| | - Maria Speranza Massei
- Pediatric Oncology-Hematology Unit, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Valentina Massetti
- Pediatric Oncology-Hematology Unit, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Elena Legnani
- Hematology-Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Ilaria Puglisi
- Hematology-Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giulia Zucchetti
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Torino, Italy
| | - Paola Quarello
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Torino, Italy
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Schwartz-Attias I, David T, Amromin T, Bar-Yosef M, Bartov Y, Ben Yaakov O, Bernstein L, Broitman M, Cohen A, Cohen O, Eisenberg L, Eshel N, Gindi Amsalem N, Gorelik N, Gerbi S, Raz H, Naamneh N, Nemtsov S, Pintel D, Sztrigler K, Goldberg S, Melnikov S. Recommendations from the Professional Advisory Committee on Nursing Practice When Caring for Adolescents and Young Adults with Cancer in Israel. J Adolesc Young Adult Oncol 2024; 13:235-238. [PMID: 37889616 DOI: 10.1089/jayao.2023.0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023] Open
Affiliation(s)
- Irit Schwartz-Attias
- Academic Nursing School, Meir Medical Center, Clalit Health Services, Kefer-Sava, Israel
| | - Tova David
- Nursing Administration and Hematology Day Care, Assuta Medical Center, Tel Aviv, Israel
| | | | - Michal Bar-Yosef
- Department of Oncology and Pediatric Hematology Oncology and Bone Marrow Transplantation, Sourasky, Tel-Aviv Medical Center, Tel Aviv, Israel
| | - Yael Bartov
- Ziva Tal Academic School of Nursing and AYA Clinical Day Care and Oncology, Sheba Medical Center, Tel Hashomer, Israel
| | - Orna Ben Yaakov
- Department of Oncology, Rambam Health Care Campus, Haifa, Israel
| | | | - Marcela Broitman
- Department of Oncology and Pediatric Hematology Oncology and Bone Marrow Transplantation, Sourasky, Tel-Aviv Medical Center, Tel Aviv, Israel
| | - Amira Cohen
- Nursing Administration, Shamir Medical Center, Tzrifin, Israel
| | - Osnat Cohen
- Department of Oncology, Rabin Medical Center, Petah Tikva, Israel
| | - Limor Eisenberg
- National Head Nurse Office, Nursing Division, Ministry of Health, Jerusalem, Israel
| | - Nurit Eshel
- Nursing Administration, Clalit Health Services, Tel Aviv, Israel
| | - Nati Gindi Amsalem
- Ziva Tal Academic School of Nursing and AYA Clinical Day Care and Oncology, Sheba Medical Center, Tel Hashomer, Israel
| | - Natan Gorelik
- Nursing Administration and Hematology Day Care, Assuta Medical Center, Tel Aviv, Israel
| | - Shimrit Gerbi
- Ziva Tal Academic School of Nursing and AYA Clinical Day Care and Oncology, Sheba Medical Center, Tel Hashomer, Israel
| | - Haya Raz
- Nursing Department, Jerusalem College of Technology, Jerusalem, Israel
| | - Nahla Naamneh
- Nursing Administration, Leumit Health Care Services, Tel Aviv, Israel
| | - Svetlana Nemtsov
- Department of Oncology, Rambam Health Care Campus, Haifa, Israel
| | - Dalit Pintel
- Nursing Administration, Clalit Health Services, Tel Aviv, Israel
| | - Keren Sztrigler
- Pediatric Hematology-Oncology Day Care, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Shoshy Goldberg
- National Head Nurse Office, Nursing Division, Ministry of Health, Jerusalem, Israel
| | - Semyon Melnikov
- Nursing Department, Steyer School of Health Professions, Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Holderness A, Magrath C, Hatcher H, Critoph D. "Absolutely No One Else, Other Than Yourself": Experiences of Adolescents and Young Adults with Cancer During the COVID-19 Pandemic. J Adolesc Young Adult Oncol 2024; 13:251-261. [PMID: 38019159 DOI: 10.1089/jayao.2023.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023] Open
Abstract
Introduction: The COVID-19 pandemic caused widespread disruption to the provision of health care in the United Kingdom. It posed two risks to AYACs: disruption of care and long-term adverse consequences compounding late effects. This study sought to better understand the experiences of AYACs receiving care during the pandemic and identify areas where greater support is needed. Methods: In-depth semistructured interviews with AYACs (n = 6), 16-22 years at diagnosis. Interviews were transcribed verbatim and analyzed using the principles of Giorgi's phenomenological analysis. Results: Four major themes and an interconnected theme were identified. Changes to health care meant AYACs were isolated and loss of in-person follow-up caused anxiety (theme 1). AYACs had to adapt to life with COVID-19 restrictions (theme 2). Support during the pandemic came from a variety of sources (theme 3). AYACs reported poor mental health due to a fear of relapse and contracting COVID-19 (theme 4). An additional burden for AYACs was the loss of the third person (e.g., parent) in consultations (interconnected theme). Conclusion: This study has wider implications for delivery of AYAC care, despite being set during the COVID-19 pandemic. The mental health implications will impact long-term care of these patients, and health care professionals must be aware of these to meet AYACs' holistic care needs.
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Affiliation(s)
- Ayesha Holderness
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Cameron Magrath
- Gloucestershire Hospitals NHS Foundation Trust, Gloucestershire Royal Hospital, Gloucester, United Kingdom
| | - Helen Hatcher
- Department of Oncology and TYA Cancer Service, University of Cambridge, Cambridge, United Kingdom
| | - Deborah Critoph
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
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Neylon K, Condren C, Guerin S, Looney K. What Are the Psychosocial Needs of Adolescents and Young Adults with Cancer? A Systematic Review of the Literature. J Adolesc Young Adult Oncol 2023; 12:799-820. [PMID: 37130327 DOI: 10.1089/jayao.2022.0130] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
Adolescents and young adults with cancer (AYACs) have become recognized as a unique group in recent years. The unique developmental context and related challenges of being a young person with a cancer diagnosis can lead to a distinct and diverse set of psychosocial issues. Existing research has attempted to explore these psychosocial needs and challenges and to develop appropriate and individualized interventions. However, the needs of this group remain unmet, with ongoing calls for individualized support. This systematic review addressed the research question, "what are the psychosocial needs of AYACs aged 15-24 years?." PubMed, PsycINFO, and CINAHL databases were searched to identify relevant studies from January 2000 to December 2022 (inclusive). Qualitative, quantitative, and mixed methods designs were included and 29 studies met inclusion criteria. Findings provide an overview of needs from the existing literature and support the idea of a changing constellation of psychosocial needs for AYACs in areas such as identity, relationships, mental health, autonomy, and occupation. The main implications for theory and future research include the importance of the developmental context and consideration of discrepancies in the age range used within the literature to define this group.
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Affiliation(s)
- Karen Neylon
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Caoimhe Condren
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Suzanne Guerin
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Kathy Looney
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
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Bolliger C, Holmer P, Dehler S, Roser K, Michel G. Posttraumatic growth and illness perception in survivors of adolescent and young adult cancer. Discov Oncol 2023; 14:194. [PMID: 37902874 PMCID: PMC10616015 DOI: 10.1007/s12672-023-00810-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 10/20/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Adolescents and young adults (AYAs) are diagnosed with cancer during a challenging period of life. We aimed to (1) describe positive changes (posttraumatic growth; PTG) and illness perception, and (2) determine associations between PTG and illness perception, sociodemographic, and cancer-related characteristics in Swiss AYA cancer survivors. METHODS We conducted a population-based survey among AYA cancer survivors diagnosed 1990-2005 at age 16-25 years, who had survived ≥ 5 years. We used the Posttraumatic Growth Inventory (PTGI) and the Brief Illness Perception Questionnaire (BIPQ). Data were analyzed using descriptive statistics and linear regressions. RESULTS Among 389 contacted survivors, 160 responded (61.3% male; mean age = 34 years, SD = 5.8). The mean PTG sum score was 54.63 (SD = 20.24; range: 8-101). Survivors reported high PTG especially in the domains Appreciation of life (mean = 3.23; 95% confidence interval, 3.05-3.40), Personal strength (2.94; 2.77-3.12), and Relating to others (2.57; 2.40-2.74). Neither sociodemographic nor cancer-related characteristics were associated with PTG. Survivors who perceived follow-up care as helpful (p < 0.001) and those with high concerns about the consequences of the illness (p < 0.001) reported higher PTG. CONCLUSIONS Finding ways to promote PTG and to identify and address maladaptive illness perceptions may help survivors transform their experience into something meaningful for their future life.
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Affiliation(s)
- Céline Bolliger
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Pauline Holmer
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Silvia Dehler
- Cancer Registry Zurich and Zug, Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Office of Public Health, Vaduz, Principality of Liechtenstein
| | - Katharina Roser
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
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Altherr A, Bolliger C, Kaufmann M, Dyntar D, Scheinemann K, Michel G, Mader L, Roser K. Education, Employment, and Financial Outcomes in Adolescent and Young Adult Cancer Survivors-A Systematic Review. Curr Oncol 2023; 30:8720-8762. [PMID: 37887531 PMCID: PMC10604989 DOI: 10.3390/curroncol30100631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/11/2023] [Accepted: 09/02/2023] [Indexed: 10/28/2023] Open
Abstract
Adolescents and young adults (AYAs) with cancer face unique challenges. We aimed to describe (i) education, employment, and financial outcomes and (ii) determinants for adverse outcomes in AYA cancer survivors. We performed a systematic literature search. We included original research articles on AYA (15-39 years of age) cancer survivors (≥2 years after diagnosis) and our outcomes of interest. We narratively synthesized the results of the included articles. We included 35 articles (24 quantitative and 11 qualitative studies). Patients in education had to interrupt their education during cancer treatment, and re-entry after treatment was challenging. After treatment, most survivors were employed but started their employment at an older age than the general population. Overall, no disadvantages in income were found. Survivors reported more absent workdays than comparisons. We identified chemotherapy, radiotherapy, late effects or health problems, female sex, migration background, and lower education associated with adverse outcomes. Although most AYA cancer survivors were able to re-enter education and employment, they reported difficulties with re-entry and delays in their employment pathway. To facilitate successful re-entry, age-tailored support services should be developed and implemented.
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Affiliation(s)
- Aurelia Altherr
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Céline Bolliger
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Michaela Kaufmann
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Daniela Dyntar
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
- Cancer Registry of Central Switzerland, 6000 Lucerne, Switzerland
| | - Katrin Scheinemann
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
- Division of Hematology & Oncology, Children’s Hospital of Eastern Switzerland, 9006 St. Gallen, Switzerland
- Department of Pediatrics, McMaster Children’s Hospital and McMaster University, Hamilton, ON L8N 3Z5, Canada
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Luzius Mader
- Institute of Social and Preventive Medicine, University of Bern, 3012 Bern, Switzerland;
- Cancer Registry Bern-Solothurn, University of Bern, 3008 Bern, Switzerland
| | - Katharina Roser
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
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Hughes L, Fern LA, Whelan JS, Taylor RM, Study Group B. Young people's opinions of cancer care in England: the BRIGHTLIGHT cohort. BMJ Open 2023; 13:e069910. [PMID: 37730384 PMCID: PMC10514633 DOI: 10.1136/bmjopen-2022-069910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 07/31/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVES The BRIGHTLIGHT cohort study was the national evaluation of cancer services for teenager and young adults (TYA). This was analysis of free-text survey data to better understand their experiences of cancer care. DESIGN Cohort study SETTING: National Health Service hospitals delivering cancer care in England PARTICIPANTS: 830 young people newly diagnosed with cancer. INTERVENTIONS Exposure to specialist care in the first 6 months after diagnosis defined as care in a TYA Principal Treatment Centre (PTC). This was categorised as follows: all care in a TYA-PTC (ALL-TYA-PTC), no care in a TYA-PTC (NO-TYA-PTC) so care delivered in a children/adult unit only and some care in a TYA-PTC with additional care in a children's/adult unit (SOME-TYA-PTC). PRIMARY OUTCOME Data were collected through the BRIGHTLIGHT survey included free-text questions which asked patients 'what was the best aspects of their experiences of care' and 'what aspects could be improved'. These comments were analysed using content analysis. Themes were compared between categories of care, then ranked in order of frequency, ranging from the most endorsed to the least. RESULTS Overall, young people were most positive about their healthcare team, while the area highlighted for improvement was diagnostic experience. Differences between the three groups suggested those who had some or all treatment in a TYA-PTC valued the place of care. Regardless of where TYA were treated their healthcare teams were favourably viewed. Age appropriate place of care was highlighted to be of value for those in PTCs. CONCLUSIONS These data show the value young people placed on the care they received in TYA specific wards. Young people who accessed some or all of their care in a TYA-PTC highly endorsed their place of care as one of the best elements of their care, and it is further emphasised by those who had shared care who experienced difficulty with lack of age-appropriate care when treated outside the TYA-PTC.
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Affiliation(s)
- Luke Hughes
- Cancer Clinical Trials Unit, University College London Hospitals NHS Foundation Trust, London, London, UK
| | - Lorna A Fern
- Cancer Clinical Trials Unit, University College London Hospitals NHS Foundation Trust, London, London, UK
| | - Jeremy S Whelan
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Rachel M Taylor
- Centre for Nurse, Midwife and Allied Health Profession Led Research (CNMAR), University College London Hospitals NHS Foundation Trust, London, UK
| | - Brightlight Study Group
- Cancer Clinical Trials Unit, University College London Hospitals NHS Foundation Trust, London, London, UK
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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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9
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Establishment, Maintenance, and Performance of the Cooperative Osteosarcoma Study Group (COSS). Cancers (Basel) 2023; 15:cancers15051520. [PMID: 36900310 PMCID: PMC10000534 DOI: 10.3390/cancers15051520] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/22/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023] Open
Abstract
INTRODUCTION Osteosarcoma treatment has benefitted greatly from collaborative research. This paper describes the history and accomplishments of the Cooperative Osteosarcoma Study Group (COSS), mainly dedicated to clinical questions, as well as remaining challenges. MATERIALS AND METHODS Narrative review of over four decades of uninterrupted collaboration within the multi-national German-Austrian-Swiss COSS group. RESULTS Since its very first prospective osteosarcoma trial starting in 1977, COSS has continuously been able to provide high-level evidence on various tumor- and treatment-related questions. This includes both the cohort of patients enrolled into prospective trials as well as those patients excluded from them for various reasons, followed in a prospective registry. Well over one hundred disease-related publications attest to the group's impact on the field. Despite these accomplishments, challenging problems remain. DISCUSSION Collaborative research within a multi-national study group resulted in better definitions of important aspects of the most common bone tumor, osteosarcoma, and its treatments. Important challenges continue to persist.
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10
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Ferrari A, Quarello P, Mascarin M, Luigi Banna G, Toss A, Sironi G, Zecca M, Cinieri S, Alessandro Peccatori F. Italian pediatric and adult oncology communities join forces for a national project dedicated to adolescents and young adults with cancer. TUMORI JOURNAL 2021; 108:104-110. [PMID: 34841968 DOI: 10.1177/03008916211058790] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Adolescents and young adults with cancer have substantially different clinical and psychological needs compared to those of pediatric patients and of older adult patients. We describe the development of an Italian national project dedicated to adolescents and young adults with cancer.
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Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Paola Quarello
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Torino, University of Torino, Italy
| | - Maurizio Mascarin
- AYA and Pediatric Radiotherapy Unit, Centro di Riferimento Oncologico, Aviano, Italy
| | - Giuseppe Luigi Banna
- Interdisciplinary Group for Translational Research and Clinical Trials, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - Angela Toss
- Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Italy
| | - Giovanna Sironi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Marco Zecca
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Saverio Cinieri
- Medical Oncology Unit and Breast Unit, Ospedale Perrino ASL Brindisi, Italy
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11
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Adolescent and Young Adult (AYA) Cancer Survivorship Practices: An Overview. Cancers (Basel) 2021; 13:cancers13194847. [PMID: 34638332 PMCID: PMC8508173 DOI: 10.3390/cancers13194847] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/25/2021] [Accepted: 09/25/2021] [Indexed: 12/24/2022] Open
Abstract
Worldwide, more than 1.2 million adolescents and young adults (AYAs; those aged 15-39 years) are diagnosed with cancer each year. Although considerable variability exists according to cancer site and stage of disease, the 5-year relative survival at the time of diagnosis has been estimated at >80% for all AYA patients with cancer combined. Extensive survivorship research in recent decades has focused on patients diagnosed with cancer as children (<15 years) and older adults (>39 years), yet few studies to date have reported outcomes specifically for patients diagnosed as AYAs. With increasing incidence and improving survival for many tumor types, leading to the majority of AYA patients with cancer becoming long-term survivors, there is a critical need for research efforts to inform the survivorship care of this growing population. This article describes the population of AYA cancer survivors according to their epidemiology and late and long-term effects, the challenges and models of AYA survivorship care, as well as future opportunities for research and healthcare.
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12
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Blais S, Cohen-Gogo S, Gouache E, Guerrini-Rousseau L, Brethon B, Rahal I, Petit A, Raimondo G, Pellegrino B, Orbach D. End-of-life care in children and adolescents with cancer: perspectives from a French pediatric oncology care network. TUMORI JOURNAL 2021; 108:223-229. [PMID: 33940999 DOI: 10.1177/03008916211013384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In developed countries, cancer remains the leading cause of pediatric death from illness after the neonatal period. OBJECTIVE To describe the end-of-life care characteristics of children and adolescents with solid tumors (ST) or hematologic malignancies (HM) who died from tumor progression in the Île-de-France area. METHODS This is a regional, multicentric, retrospective review of medical files of all children and adolescents with cancer who died over a 1-year period. Extensive data from the last 3 months of life were collected. RESULTS A total of 99 eligible patients died at a median age of 9.8 years (range, 0.3-24 years). The most frequent terminal symptoms were pain (n = 86), fatigue (n = 84), dyspnea (n = 49), and anorexia (n = 41). Median number of medications per patient was 8 (range, 3-18). Patients required administration of opioids (n = 91), oxygen (n = 36), and/or sedation (n = 61). Decision for palliative care was present in all medical records and do-not-resuscitate orders in 90/99 cases. Symptom prevalence was comparable between children and adolescents with ST and HM. A wish regarding the place of death had been expressed for 64 patients and could be respected in 42 cases. Death occurred in hospital for 75 patients. CONCLUSIONS This study represents a large and informative cohort illustrating current pediatric palliative care approaches in pediatric oncology. End-of-life remains an active period of care requiring coordination of multiple care teams.
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Affiliation(s)
- Sophie Blais
- Pediatric Department, Poissy Hospital, Poissy, France
| | - Sarah Cohen-Gogo
- Division of Hematology and Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada
| | - Elodie Gouache
- Department of Pediatric Hematology, Trousseau Hospital (AP-HP), Sorbonne University, Paris, France
| | - Lea Guerrini-Rousseau
- Gustave Roussy Cancer Center, Department of Pediatric and Adolescent Oncology, Paris-Saclay University, Villejuif, France
| | - Benoit Brethon
- Pediatric Hematology Department, Robert Debré Hospital (AP-HP), Paris, France.,RIFHOP, Île-de-France Regional Network of Pediatric Hematology-Oncology, Paris, France
| | - Ilhem Rahal
- Adolescents and Young Adults Hematology Department, Saint-Louis Hospital (AP-HP), Paris, France
| | - Arnaud Petit
- Department of Pediatric Hematology, Trousseau Hospital (AP-HP), Sorbonne University, Paris, France
| | - Graziella Raimondo
- Department of Pediatric Hematology and Oncology, Hôpital d'Enfants Margency, Margency, France.,PALIPED, Regional Pediatric Palliative Care Resource Team of Île-de-France, Paris, France
| | - Beatrice Pellegrino
- Pediatric Department, Poissy Hospital, Poissy, France.,RIFHOP, Île-de-France Regional Network of Pediatric Hematology-Oncology, Paris, France.,PALIPED, Regional Pediatric Palliative Care Resource Team of Île-de-France, Paris, France
| | - Daniel Orbach
- RIFHOP, Île-de-France Regional Network of Pediatric Hematology-Oncology, Paris, France.,SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
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13
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Bozovic-Spasojevic I, Balsat M, Blondeel A, Castleton A, De Munter J, Gamble AS, Kienesberger A, Konsoulova-Kirova AA, Rizvi K, Schneider C, Vermeersch J, Ferrari A, Stark D. A European Network for Teenagers and Young Adults with Cancer. J Adolesc Young Adult Oncol 2021; 10:117-119. [PMID: 33847510 DOI: 10.1089/jayao.2021.0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Marie Balsat
- Department of Hematology, Lyon-Sud Hospital, Hospices Civils de Lyon, Lyon, France
| | - Anne Blondeel
- The European Society for Paediatric Oncology, Brussels, Belgium
| | | | | | - Ashley S Gamble
- Children's Cancer and Leukaemia Group, Leicester, United Kingdom
| | | | | | | | - Carina Schneider
- CCI Europe, Vienna, Austria.,Medical University of Vienna, Vienna, Austria
| | | | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Daniel Stark
- Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds, United Kingdom
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14
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Ferrari A, Stark D, Peccatori FA, Fern L, Laurence V, Gaspar N, Bozovic-Spasojevic I, Smith O, De Munter J, Derwich K, Hjorth L, van der Graaf WTA, Soanes L, Jezdic S, Blondeel A, Bielack S, Douillard JY, Mountzios G, Saloustros E. Adolescents and young adults (AYA) with cancer: a position paper from the AYA Working Group of the European Society for Medical Oncology (ESMO) and the European Society for Paediatric Oncology (SIOPE). ESMO Open 2021; 6:100096. [PMID: 33926710 PMCID: PMC8103533 DOI: 10.1016/j.esmoop.2021.100096] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 12/17/2022] Open
Abstract
It is well recognised that adolescents and young adults (AYA) with cancer have inequitable access to oncology services that provide expert cancer care and consider their unique needs. Subsequently, survival gains in this patient population have improved only modestly compared with older adults and children with cancer. In 2015, the European Society for Medical Oncology (ESMO) and the European Society for Paediatric Oncology (SIOPE) established the joint Cancer in AYA Working Group in order to increase awareness among adult and paediatric oncology communities, enhance knowledge on specific issues in AYA and ultimately improve the standard of care for AYA with cancer across Europe. This manuscript reflects the position of this working group regarding current AYA cancer care, the challenges to be addressed and possible solutions. Key challenges include the lack of specific biological understanding of AYA cancers, the lack of access to specialised centres with age-appropriate multidisciplinary care and the lack of available clinical trials with novel therapeutics. Key recommendations include diversifying interprofessional cooperation in AYA care and specific measures to improve trial accrual, including centralising care where that is the best means to achieve trial accrual. This defines a common vision that can lead to improved outcomes for AYA with cancer in Europe.
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Affiliation(s)
- A Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
| | - D Stark
- Leeds Institute of Medical Research, School of Medicine University of Leeds, Leeds, UK.
| | - F A Peccatori
- Gynecologic Oncology Department, European Institute of Oncology IRCCS, Milan, Italy
| | - L Fern
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - V Laurence
- Medical Oncology Department and SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, Paris, France
| | - N Gaspar
- Department of Oncology for Child and Adolescent, Gustave Roussy Cancer Campus, Villejuif, France
| | - I Bozovic-Spasojevic
- Medical Oncology Department, Institute for Oncology and Radiology of Serbia, Belgrade, Republic of Serbia
| | - O Smith
- National Children's Cancer Service, Children's Health Ireland at Crumlin and Systems Biology Ireland, University College Dublin, Dublin, Ireland
| | - J De Munter
- University Hospital Ghent Cancer Center, UZ Gent, Ghent, Belgium
| | - K Derwich
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - L Hjorth
- Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Pediatrics, Lund, Sweden
| | - W T A van der Graaf
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - L Soanes
- Teenage Cancer Trust, London, UK
| | - S Jezdic
- Scientific and Medical Division, European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - A Blondeel
- Department of Scientific Programme Coordination, European Society for Paediatric Oncology (SIOPE), Brussels, Belgium
| | - S Bielack
- Zentrum für Kinder, Jugend und Frauenmedizin Pädiatrie 5, KlinikumStuttgart - Olgahospital, Stuttgart, Germany
| | - J-Y Douillard
- Scientific and Medical Division, European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - G Mountzios
- 2nd Department of Medical Oncology and Clinical Trial Unit, Henry Dunant Hospital, Athens, Greece
| | - E Saloustros
- Department of Oncology, University Hospital of Larissa, Larissa, Greece
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15
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Al-Jamaei AAH, van Dijk BAC, Helder MN, Forouzanfar T, Leemans CR, de Visscher JGAM. A population-based study of the epidemiology of oral squamous cell carcinoma in the Netherlands 1989-2018, with emphasis on young adults. Int J Oral Maxillofac Surg 2021; 51:18-26. [PMID: 33773877 DOI: 10.1016/j.ijom.2021.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/28/2021] [Accepted: 03/09/2021] [Indexed: 12/24/2022]
Abstract
There has been an increasing trend in oral squamous cell carcinoma (OSCC) in patients under 45 years of age. The aim of this study was to evaluate the burden of OSCC in the Netherlands between 1989 and 2018 among young adults (age 20-34 years) when compared to adults (age 35-44 years), and to describe the burden in older groups as well, utilizing cancer registry data to characterize incidence patterns by age, sex, and risk factors. A total of 18,963 cases of OSCC were reported. The overall incidence rate, as measured by annual percentage change (APC), increased significantly from 1989 to 2010 by 1.3% per year (95% confidence interval (CI) 0.9-1.7%) but decreased thereafter by -0.9% (95% CI -2.5% to 0.7%). Annual incidence increased significantly by 2.4% (95% CI 1.1-3.8%) for patients aged 20-34 years, while it decreased for those aged 35-44 years by -0.9% (95% CI -1.7% to 0.0%). In patients older than 60 years, incidence rates increased overall (60-74 years: APC 1.8%, 95% CI 1.5-2.1%; ≥75 years: APC 1.5%, 95% CI 1.2-1.9%). Overall, 66.5% of patients were smokers and 65.3% were alcohol consumers. The marked differences in incidence within the young age subgroups warrants further investigation to elucidate any likely disparity in biological process and clinical outcomes in these populations.
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Affiliation(s)
- A A H Al-Jamaei
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC-location VUMC/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - B A C van Dijk
- Netherlands Comprehensive Cancer Organization (IKNL), Department of Research and Development, Utrecht, The Netherlands; Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M N Helder
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC-location VUMC/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - T Forouzanfar
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC-location VUMC/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - C R Leemans
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC-location VUMC, Amsterdam, The Netherlands
| | - J G A M de Visscher
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC-location VUMC/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
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Gadolin C, Eriksson E, Alexandersson P. Coordination of paediatric oncology care: an explorative Swedish case study. JOURNAL OF INTEGRATED CARE 2021. [DOI: 10.1108/jica-10-2020-0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The aim of this paper is to empirically describe and analyze factors deemed to be relevant for the successful provision of coordinated paediatric oncology care by physicians and nurses involved.
Design/methodology/approach
A qualitative case study primarily consisting of interviews.
Findings
The paper's findings indicate that certain factors (i.e. distinct mission, clear treatment protocols and support from external stakeholders) relevant for the provision of coordinated paediatric oncology care have not received sufficient attention in previous research. In addition, emphasis is placed on the necessity of facilitating constructive working relationships and a bottom-up perspective when pursuing improved care coordination.
Originality/value
The factors described and analyzed may act as insights for how paediatric oncology might be improved in terms of care coordination and thus facilitate care integration. In addition, the paper's findings identify factors relevant for further empirical studies in order to delineate their generalizability.
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17
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Cancer survivorship: Reproductive health outcomes should be included in standard toxicity assessments. Eur J Cancer 2021; 144:310-316. [DOI: 10.1016/j.ejca.2020.11.032] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/17/2020] [Accepted: 11/24/2020] [Indexed: 12/13/2022]
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18
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Taylor RM, Fern LA, Barber J, Alvarez-Galvez J, Feltbower R, Lea S, Martins A, Morris S, Hooker L, Gibson F, Raine R, Stark DP, Whelan J. Longitudinal cohort study of the impact of specialist cancer services for teenagers and young adults on quality of life: outcomes from the BRIGHTLIGHT study. BMJ Open 2020; 10:e038471. [PMID: 33243793 PMCID: PMC7692812 DOI: 10.1136/bmjopen-2020-038471] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES In England, healthcare policy advocates specialised age-appropriate services for teenagers and young adults (TYA), those aged 13 to 24 years at diagnosis. Specialist Principal Treatment Centres (PTC) provide enhanced TYA age-specific care, although many still receive care in adult or children's cancer services. We present the first prospective structured analysis of quality of life (QOL) associated with the amount of care received in a TYA-PTC DESIGN: Longitudinal cohort study. SETTING Hospitals delivering inpatient cancer care in England. PARTICIPANTS 1114 young people aged 13 to 24 years newly diagnosed with cancer. INTERVENTION Exposure to the TYA-PTC defined as patients receiving NO-TYA-PTC care with those receiving ALL-TYA-PTC and SOME-TYA-PTC care. PRIMARY OUTCOME Quality of life measured at five time points: 6, 12, 18, 24 and 36 months after diagnosis. RESULTS Group mean total QOL improved over time for all patients, but for those receiving NO-TYA-PTC was an average of 5.63 points higher (95% CI 2.77 to 8.49) than in young people receiving SOME-TYA-PTC care, and 4·17 points higher (95% CI 1.07 to 7.28) compared with ALL-TYA-PTC care. Differences were greatest 6 months after diagnosis, reduced over time and did not meet the 8-point level that is proposed to be clinically significant. Young people receiving NO-TYA-PTC care were more likely to have been offered a choice of place of care, be older, from more deprived areas, in work and have less severe disease. However, analyses adjusting for confounding factors did not explain the differences between TYA groups. CONCLUSIONS Receipt of some or all care in a TYA-PTC was associated with lower QOL shortly after cancer diagnosis. The NO-TYA-PTC group had higher QOL 3 years after diagnosis, however those receiving all or some care in a TYA-PTC experienced more rapid QOL improvements. Receipt of some care in a TYA-PTC requires further study.
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Affiliation(s)
- Rachel M Taylor
- Centre for Nurse, Midwife and AHP Led Research (CNMAR), University College London Hospitals NHS Foundation Trust, London, UK
| | - Lorna A Fern
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Julie Barber
- Department of Statistical Science, University College, London, UK
| | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cadiz, Spain
| | | | - Sarah Lea
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Ana Martins
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Stephen Morris
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Louise Hooker
- Wessex Teenage and Young Adult Cancer Service, University Hospital Southampton, Southampton, UK
| | - Faith Gibson
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Rosalind Raine
- Department of Applied Health Research, University College London, London, UK
| | - Dan P Stark
- Leeds Insitute of Molecular Medicine, University of Leeds, Leeds, UK
| | - Jeremy Whelan
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
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19
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Girardi F, Allemani C, Coleman MP. Global Trends in Survival From Astrocytic Tumors in Adolescents and Young Adults: A Systematic Review. JNCI Cancer Spectr 2020; 4:pkaa049. [PMID: 33134829 PMCID: PMC7583144 DOI: 10.1093/jncics/pkaa049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background Brain tumors represent an important cause of cancer-related death in adolescents and young adults. Most are diagnosed in low-income and middle-income countries. We aimed to conduct the first, to our knowledge, systematic review of time trends and geographical variation in survival in this age group. Methods We included observational studies describing population-based survival from astrocytic tumors in patients aged 15-39 years. We queried 6 electronic databases from database inception to December 31, 2019. This review is registered with PROSPERO, number CRD42018111981. Results Among 5640 retrieved records, 20 studies fulfilled the inclusion criteria. All but 1 study focused on high-income countries. Five-year survival from astrocytoma (broad morphology group) mostly varied between 48.0% and 71.0% (1973-2004) without clear trends or geographic differences. Adolescents with astrocytoma had better outcomes than young adults, but survival values were similar when nonmalignant tumors were excluded. During 2002-2007, 5-year survival for World Health Organization grade I-II tumors was in the range of 72.6%-89.1% in England, Germany, and the United States but lower in Southeastern Europe (59.0%). Five-year survival for anaplastic astrocytoma varied between 39.6% and 55.4% (2002-2007). Five-year survival from glioblastoma was in the range of 14.2%-23.1% (1991-2009). Conclusions Survival from astrocytic tumors remained somewhat steady over time, with little change between 1973 and 2009. Survival disparities were difficult to examine, because nearly all the studies were conducted in affluent countries. Studies often adopted the International Classification of Childhood Cancer, which, however, did not allow to accurately describe variation in survival. Larger studies are warranted, including underrepresented populations and providing more recent survival estimates.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, Non-Communicable Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Claudia Allemani
- Cancer Survival Group, Non-Communicable Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Michel P Coleman
- Cancer Survival Group, Non-Communicable Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London, UK
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20
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Park M, Lim J, Lee JA, Park BK, Jung KW, Won YJ, Park HJ. Cancer Incidence and Survival among Adolescents and Young Adults in Korea: An Update for 2016. Cancer Res Treat 2020; 53:32-44. [PMID: 33017883 PMCID: PMC7811995 DOI: 10.4143/crt.2020.644] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/29/2020] [Indexed: 11/21/2022] Open
Abstract
PURPOSE This study investigated the incidence and relative survival rates (RSRs) for cancers among adolescents and young adults (AYAs) aged 15-39 years between 1993 and 2016 in Korea. Materials and Methods Data from the Korea Central Cancer Registry were used to calculate percent distributions, age-specific incidence rates, age-standardized incidence rates (ASRs) per million, annual percent changes (APCs), average APCs, and RSRs for cancers diagnosed in AYAs. RESULTS ASR of all cancers among AYAs was 654.5 per million. The largest diagnosed group of cancers was carcinomas (almost 80%). Crude incidence increased with age, from 170.4 per million for those aged 15-19 years to 1,639.8 per million for those aged 35-39 years. ASR increased from 414.8 per million to 820.4 per million, with an APC of 9.0%. The incidence of thyroid carcinoma showed the most rapid increment (APC, 14.0%), followed by non-Hodgkin lymphoma (APC, 13.4%). The 5-year RSR among AYAs significantly improved from 62.1% to 90.8%. Survival improvement in AYAs was higher than that in children but lower than that in older adults (APC, 2.1% vs. 1.9% vs. 3.1%). The most marked survival improvement was found for leukemia and lymphoma. Astrocytoma, rhabdomyosarcoma, and carcinoma of the trachea, bronchus, and lung had a 5-year RSR of < 50%. CONCLUSION There was an improvement in cancer survivals in AYAs, comparable to that achieved in children. However, survivals in several cancer types do not appear to be improving. Further research focusing on the epidemiology and therapeutic strategies for cancers in AYAs is needed.
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Affiliation(s)
- Meerim Park
- Department of Pediatrics, Center for Pediatric Cancer, National Cancer Center, Goyang, Korea
| | - Jiwon Lim
- Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea
| | - Jun Ah Lee
- Department of Pediatrics, Center for Pediatric Cancer, National Cancer Center, Goyang, Korea
| | - Byung Kiu Park
- Department of Pediatrics, Center for Pediatric Cancer, National Cancer Center, Goyang, Korea
| | - Kyu-Won Jung
- Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea
| | - Young-Joo Won
- Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea
| | - Hyeon Jin Park
- Department of Pediatrics, Center for Pediatric Cancer, National Cancer Center, Goyang, Korea
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21
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Shoji T, Kanamori M, Saito R, Watanabe Y, Watanabe M, Fujimura M, Ogawa Y, Sonoda Y, Kumabe T, Kure S, Tominaga T. Frequent Clinical and Radiological Progression of Optic Pathway/Hypothalamic Pilocytic Astrocytoma in Adolescents and Young Adults. Neurol Med Chir (Tokyo) 2020; 60:277-285. [PMID: 32404575 PMCID: PMC7301130 DOI: 10.2176/nmc.oa.2019-0208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Most cases of optic hypothalamic pilocytic astrocytoma (OHPA) develop during childhood, so few cases of histologically verified OHPA have been described in adolescents and young adults (AYA). To elucidate the clinical features of OHPA with histological verification in AYA, we reviewed the clinical and radiological finding of OHPA treated at our institute from January 1997 and July 2017. AYA are aged between 15 and 39 years. The clinical courses of 11 AYA patients with optic hypothalamic glioma (OHG) without neurofibromatosis type 1 were retrospectively reviewed. About six patients were diagnosed in childhood and followed up after 15 years of age, and five patients developed OHPA during AYA. Histological diagnosis, verified at initial presentation or recurrence, was pilocytic astrocytoma in 10 and pilomyxoid astrocytoma in one. After initial treatment including debulking surgery and/or chemotherapy, tumor progression occurred 16 times in seven patients as cyst formation, tumor growth, and intratumoral hemorrhage. Five of 10 patients suffered deterioration of visual function during AYA. One of 10 cases had endocrinopathies requiring hormone replacement at last follow-up examination. In conclusion, histological diagnoses of OHG before and in AYA were pilocytic astrocytoma or pilomyxoid astrocytoma. Both pediatric and AYA-onset OHPA demonstrate high incidences of tumor progression and visual dysfunctions in AYA, so that long-term follow up is essential after the completion of treatment for pediatric and AYA-onset OHPA. The optimal timing of debulking surgery and radiation therapy should be established to achieve the long-term tumor control and to preserve the visual function.
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Affiliation(s)
- Takuhiro Shoji
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Masayuki Kanamori
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Ryuta Saito
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Yuko Watanabe
- Department of Pediatrics, Tohoku University Graduate School of Medicine
| | | | | | | | | | | | - Shigeo Kure
- Department of Pediatrics, Tohoku University Graduate School of Medicine
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
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22
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Evolving Services for Adolescents with Cancer in Italy: Access to Pediatric Oncology Centers and Dedicated Projects. J Adolesc Young Adult Oncol 2020; 9:196-201. [DOI: 10.1089/jayao.2019.0134] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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23
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de Rojas T, Neven A, Terada M, García-Abós M, Moreno L, Gaspar N, Péron J. Access to Clinical Trials for Adolescents and Young Adults With Cancer: A Meta-Research Analysis. JNCI Cancer Spectr 2019; 3:pkz057. [PMID: 32337483 PMCID: PMC7050014 DOI: 10.1093/jncics/pkz057] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/15/2019] [Accepted: 07/29/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The 18-year-old age limit for inclusion in clinical trials constitutes a hurdle for adolescents and young adults (AYAs) with cancer. We analyzed the impact of this age barrier on the access of AYAs to cancer trials and novel therapies. METHODS ClinicalTrials.gov was searched to identify all the trials including patients with 10 malignancies relevant for AYAs (January 2007 to July 2018). The trials were categorized as pediatric (patients <18 y), adult (≥18 y), and transitional (including adult and pediatric patients). Transitional trials with a lower limit between 12 and 18 years and an upper limit younger than 40 years were considered AYA-specific. RESULTS Of 2764 identified trials, 2176 were included: 79% adult, 19% transitional, 2% pediatric. Five trials were AYA-specific. The proportion of academic trials was higher for transitional (69%; 288 of 421) than for adult trials (48%; 832 of 1718) (P < .0001). The total number of new trials increased over the years (156 in 2007; 228 in 2017); however, the number of transitional trials remained stable. The availability of trials increased with age, with a major increase at age 18 years: at age 17 years, 20% (442 of 2176) of trials were potentially accessible vs 95% (2075 of 2176) at 18 years. For trials investigating targeted therapies, this increase was 460% (197 trials available at age 17 years; 901 at 18 years) and for immunotherapies, 1200% (55 at age 17 years; 658 at 18 years). CONCLUSIONS AYAs have limited access to cancer trials and innovative therapies, with no improvement over the last decade. The 18-years-old age limit continues to be a major hurdle. Our findings are consistent with the internationally supported idea that age inclusion criteria in oncological trials should be changed.
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Affiliation(s)
| | | | | | - Miriam García-Abós
- European Organisation for Research and Treatment of Cancer HQ, Brussels, Belgium
- Pediatric Oncology Department, Hospital Donostia, San Sebastian, Spain
| | - Lucas Moreno
- Clinical Research Unit, Hospital Niño Jesús, Madrid, Spain
| | - Nathalie Gaspar
- Department of Oncology for Child and Adolescent, Gustave Roussy Cancer Campus, Villejuif, France
| | - Julien Péron
- Medical Department, Brussels, Belgium
- Medical Oncology Department, Institut de Cancérologie des Hospices Civils de Lyon, Université Lyon 1, Lyon, France
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24
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Osborn M, Johnson R, Thompson K, Anazodo A, Albritton K, Ferrari A, Stark D. Models of care for adolescent and young adult cancer programs. Pediatr Blood Cancer 2019; 66:e27991. [PMID: 31524328 DOI: 10.1002/pbc.27991] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 07/30/2019] [Accepted: 08/11/2019] [Indexed: 12/12/2022]
Abstract
This review draws on the experience of adolescent and young adult (AYA) cancer clinicians from Australia, the United States, and the United Kingdom to summarize common aspects of models of care implemented in their countries. The principles underpinning these models include patient- and family-focused care informed by an understanding of normal AYA development, enhancing existing adult or pediatric cancer services to meet the needs of AYA, and promoting collaboration between pediatric and adult oncologists. Common elements of AYA cancer care include establishing an AYA multidisciplinary team that integrates medical and psychosocial care, efforts to centralize complex care, providing access and equity for all AYA, promoting clinical trials, and helping facilitate transition to healthy survivorship. Several organizational approaches are described, noting that local program development depends on resources, infrastructure, and assessment of unmet needs within the region. The development of national networks provides opportunities for shared learning and approaches to evaluation.
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Affiliation(s)
- Michael Osborn
- Youth Cancer Service SA/NT, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Department of Haematology and Oncology, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Rebecca Johnson
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Adolescent and Young Adult Oncology Program, Mary Bridge Children's Health Center/MultiCare Health System, Tacoma, Washington
| | - Kate Thompson
- OnTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Antoinette Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Randwick, New South Wales, Australia
| | - Karen Albritton
- Adolescent and Young Adult Oncology, Cook Children's Medical Center, Fort Worth, Texas
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Daniel Stark
- The Leeds Institute of Cancer and Pathology, Leeds Institute of Oncology and St James's University Hospital, Leeds, UK
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25
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Survival after cancer in children, adolescents and young adults in the Nordic countries from 1980 to 2013. Br J Cancer 2019; 121:1079-1084. [PMID: 31719686 PMCID: PMC6964683 DOI: 10.1038/s41416-019-0632-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/21/2019] [Accepted: 10/23/2019] [Indexed: 01/10/2023] Open
Abstract
Background The present study aimed to assess whether the widespread concern of inferior cancer survival in adolescents and young adults (AYAs) compared with children and adults holds true in a Nordic setting with important differences in healthcare organisation compared with the United States (e.g. free access to healthcare) and the United Kingdom (e.g. young teenagers are treated in paediatric departments). Methods Five-year relative survival was calculated for 17 diagnostic groups in patients diagnosed in 2000–2013 in three diagnostic age categories: children (0–14 years), AYAs (15–24 years) and adults (25–34 years). Results For 13 out of 17 diagnostic groups examined, there was no difference in survival between AYAs and neighbouring age categories. For acute lymphoblastic leukaemias, astrocytomas, rhabdomyosarcomas and non-rhabdomyosarcoma soft tissue sarcomas we found survival in children to be superior to that in AYAs. For these four diagnostic groups, the rate of survival improvement over three calendar periods (1980–1989, 1990–1999 and 2000–2013) was not particularly low in AYAs compared with neighbouring age categories. Conclusions The present study suggests that in an affluent setting with free access to healthcare, meaningful differences in survival between AYA patients and either childhood or adult patients are a phenomenon of the past for most AYA cancer diagnostic groups.
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26
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de Rojas T, Kasper B, Van der Graaf W, Pfister SM, Bielle F, Ribalta T, Shenjere P, Preusser M, Fröhling S, Golfinopoulos V, Morfouace M, McCabe MG. EORTC SPECTA-AYA: A unique molecular profiling platform for adolescents and young adults with cancer in Europe. Int J Cancer 2019; 147:1180-1184. [PMID: 31465545 PMCID: PMC7383917 DOI: 10.1002/ijc.32651] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/10/2019] [Accepted: 08/12/2019] [Indexed: 01/01/2023]
Abstract
For most adolescent and young adult (AYA) cancers, age‐specific molecular features are poorly understood. EORTC‐SPECTA, an academic translational research infrastructure for biomaterial collection, will explicitly recruit AYA patients and will therefore collect empirical data to bridge the molecular gap between pediatric and adult oncology. The initial pilot study, activated in February 2019 across Europe, will recruit 100 AYA patients (aged 12–29 years) with newly diagnosed or relapsed high‐grade gliomas and high‐grade bone and soft tissue sarcomas. The primary objective of the pilot is to determine feasibility and recruitment rates. Formalin‐fixed tumor tissue and whole blood from study participants will be prospectively collected with clinical data and stored centrally at the Integrated BioBank of Luxembourg. Whole exome sequencing of matched tumor and blood, and tumor RNA sequencing and DNA methylation profiling will be performed at the German Cancer Research Center, Heidelberg, Germany. Virtual central pathology review of scanned diagnostic slides will be undertaken by an international expert panel, and diagnostic material returned to the participating centers. A multidisciplinary molecular tumor board will release a clinically validated report to referring clinicians within 4–6 weeks after biopsy. SPECTA‐AYA constitutes a major opportunity to gain knowledge about the tumor biology of this unique age group. It incorporates notable innovative aspects: AYA specificity, pan‐European academic collaboration, centralized biobanking, comprehensive molecular profiling and virtual central pathology review, among others. SPECTA‐AYA will help untangle the tumor particularities of AYAs with cancer and aims to improve their access to novel drugs and personalized medicine. What's new? To date, age‐specific molecular features remain poorly understood for most adolescent and young adult (AYA) cancers. This paper presents how SPECTA, a pan‐European academic translational research infrastructure for biomaterial collection, will specifically recruit AYA patients to bridge the molecular gap between pediatric and adult oncology. Further notable innovative aspects include centralized biobanking, comprehensive molecular profiling, and virtual central pathology review. SPECTA‐AYA, whose initial pilot study was launched in February 2019, constitutes a major opportunity to gain knowledge about the tumor biology of this unique age group and aims to improve the access of AYAs to novel drugs and personalized medicine.
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Affiliation(s)
| | - Bernd Kasper
- Sarcoma Unit, Mannheim University Medical Center, University of Heidelberg, Mannheim, Germany
| | - Winette Van der Graaf
- Netherlands Cancer Institute van Leeuwenhoek, Amsterdam, The Netherlands.,Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Stefan M Pfister
- Hopp Children's Cancer Center Heidelberg (KiTZ), Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) and Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Franck Bielle
- Assistance Publique-Hôpitaux de Paris, La Pitié-Salpêtrière Hospital, Department of Neuropathology, Paris, France
| | - Teresa Ribalta
- Department of Pathology, Hospital Sant Joan de Deu, Barcelona, Spain
| | - Patrick Shenjere
- Department of Histopathology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Matthias Preusser
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Stefan Fröhling
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | | | - Martin G McCabe
- Division of Cancer Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
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27
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Trama A, Botta L, Steliarova-Foucher E. Cancer Burden in Adolescents and Young Adults: A Review of Epidemiological Evidence. Cancer J 2019; 24:256-266. [PMID: 30480570 DOI: 10.1097/ppo.0000000000000346] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cancer burden in adolescents and young adults (AYAs) is expressed through a large proportion of the quality of life lost on individual level and also causes losses to the society in terms of a decreased productivity and social structure. A specific cancer spectrum and distinctive needs of AYA patients require targeted studies and cancer control measures. Incidence is intermediate between that for children and for older adults, and two-thirds of the AYA cancers affect women. Cancers of the breast and cervix uteri, representing a large portion of the burden, are amenable to prevention. Survival is relatively high, but it is lower in AYA patients with certain cancers that are common in childhood or older adulthood. Tailored cancer care with centralized multidisciplinary provision improves the outcome, as demonstrated by survival of leukemia patients. Mortality is decreasing in high-income countries for the cancers that contribute to the burden most, but lack of progress is seen for some rarer subtypes, such as brain tumors and sarcomas of the bone and soft tissue. There is unacceptable lack of information on cancer burden in low-income countries in which the outcomes for AYA patients are likely dreadful. Investment is required to establish cancer registration system and appropriate cancer care delivery in these settings.
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Affiliation(s)
| | | | - Eva Steliarova-Foucher
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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Abstract
Adolescents and young adults (AYAs) with cancer constitute a particular group of patients with unique features, whose needs during and after treatment are poorly met. A standardized model of care for them has yet to be established, as neither the pediatric nor the adult oncology systems seamlessly fit their needs. Regardless of the setting in which they are treated, their health care providers should be aware of the impact that the disease and its treatments have on these especially vulnerable patients. Simple ways of improving the AYA experience should be considered: reducing isolation through connections with peers, adapting the staff's approach to the emotional and developmental needs of this age group, and modifying the hospital environment making it more age appropriate. Commitment of national governments is valuable; building and sharing international experience will accelerate advances in clinical care, education, and research. Further progress in the care of AYA cancer patients is still needed to improve their outcomes.
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Dynamics and Challenges of Clinical Trials in Adolescents and Young Adults With Cancer. ACTA ACUST UNITED AC 2019; 24:307-314. [PMID: 30480575 DOI: 10.1097/ppo.0000000000000347] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Inclusion in cancer clinical trials is considered the optimal standard of care, offering improved patient experience and progressive survival gains for subsequent generations of patients. Adolescent and young adult (AYA) patients are underrepresented in cancer research; consequently, improvements in outcomes for AYAs lag behind their pediatric and adult counterparts. Despite international evidence of underrepresentation in research, systematically tested interventions to improve recruitment for AYAs do not exist, and recruitment rates for AYAs continue to be lower than those for children. We review recruitment of AYAs into trials and discuss barriers and facilitators.
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Courtenay M, Castro-Sánchez E, Gallagher R, McEwen J, Bulabula ANH, Carre Y, Du Toit B, Figueiredo RM, Gjerde ME, Hamilton N, Jorgoni L, Ness V, Olans R, Padoveze MC, Rout J, van Gulik N, Van Zyl Y. Development of consensus-based international antimicrobial stewardship competencies for undergraduate nurse education. J Hosp Infect 2019; 103:244-250. [PMID: 31421195 DOI: 10.1016/j.jhin.2019.08.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 08/01/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND There is growing recognition by national and international policymakers of the contribution nurses make towards antimicrobial stewardship. Although undergraduate education provides an ideal opportunity to prepare nurses for antimicrobial stewardship roles and activities, only two-thirds of undergraduate nursing programmes incorporate any antimicrobial stewardship teaching and only 12% cover all the recommended antimicrobial stewardship principles. Nurses also report that they do not have a good knowledge of antibiotics, and many have not heard of the term antimicrobial stewardship. AIM To provide international consensus on the antimicrobial stewardship competency descriptors appropriate for undergraduate nurse education. METHODS A modified Delphi approach comprising two online surveys delivered to an international panel of 15 individuals reflecting expertise in prescribing and medicines management in the education and practice of nurses; and antimicrobial stewardship. Data collection took place between February and March 2019. FINDINGS A total of 15 participants agreed to become members of the expert panel, of whom 13 (86%) completed round 1 questionnaire, and 13 (100%) completed round 2. Consensus was achieved, with consistently high levels of agreement across panel members, on six overarching competency domains and 63 descriptors, essential for antimicrobial stewardship practice. CONCLUSION The competency descriptors should be used to direct undergraduate nurse education and the antimicrobial stewardship practices of qualified nurses (including those working in new roles such as Nursing Associates) due to the high levels of agreement reached on competency descriptors.
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Affiliation(s)
- M Courtenay
- School of Healthcare Sciences, Cardiff University, Cardiff, UK.
| | - E Castro-Sánchez
- NIHR Health Protection Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, London, UK
| | | | | | - A N H Bulabula
- Tygerberg Hospital UIPC, Tygerberg, Cape Town, South Africa; Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Y Carre
- Bordeaux Hospital University Center, Bordeaux, France
| | - B Du Toit
- Mediclinic Southern Africa, Stellenbosch, South Africa
| | - R M Figueiredo
- Nursing Department, Federal University of São Carlos, São Carlos, SP, Brazil
| | - M E Gjerde
- Haukeland University Hospital, Bergen, Norway
| | - N Hamilton
- Nykoma Hamilton, NHS Fife, Kirkcaldy, UK
| | - L Jorgoni
- University Sinai Health System, Univeristy Health Network, Canada
| | - V Ness
- Glasgow Caledonian University, Glasgow, UK
| | - R Olans
- MGH Institute of Health Professions, School of Nursing, Boston, MA, USA
| | - M C Padoveze
- School of Nursing, University of São Paulo, São Paulo, Brazil
| | - J Rout
- University of KwaZulu-Natal, South Africa
| | - N van Gulik
- Ramathibodi School of Nursing, Mahidol University, Bangkok, Thailand
| | - Y Van Zyl
- Paarl Provincial Hospital, Paarl, South Africa
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Taylor RM, Fern LA, Barber J, Alvarez-Galvez J, Feltbower R, Morris S, Hooker L, McCabe MG, Gibson F, Raine R, Stark DP, Whelan JS. Description of the BRIGHTLIGHT cohort: the evaluation of teenage and young adult cancer services in England. BMJ Open 2019; 9:e027797. [PMID: 31005941 PMCID: PMC6500338 DOI: 10.1136/bmjopen-2018-027797] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE International recognition of the unique needs of young people with cancer is growing. Many countries have developed specialist age-appropriate cancer services believing them to be of value. In England, 13 specialist principal treatment centres (PTCs) deliver cancer care to young people. Despite this expansion of specialist care, systematic investigation of associated outcomes and costs has, to date, been lacking. The aim of this paper is to describe recruitment and baseline characteristics of the BRIGHTLIGHT cohort and the development of the bespoke measures of levels of care and disease severity, which will inform the evaluation of cancer services in England. DESIGN Prospective, longitudinal, observational study. SETTING Ninety-seven National Health Service hospitals in England. PARTICIPANTS A total of 1114 participants were recruited and diagnosed between July 2012 and December 2014: 55% (n=618) were men, mean age was 20.1 years (SD=3.3), most (86%) were white and most common diagnoses were lymphoma (31%), germ cell tumour (19%) and leukaemia (13%). RESULTS At diagnosis, median quality of life score was significantly lower than a published control threshold (69.7 points); 40% had borderline to severe anxiety, and 21% had borderline to severe depression. There was minimal variation in other patient-reported outcomes according to age, diagnosis or severity of illness. Survival was lower in the cohort than for young people diagnosed during the same period who were not recruited (cumulative survival probability 4 years after diagnosis: 88% vs 92%). CONCLUSIONS Data collection was completed in March 2018. Longitudinal comparisons will determine outcomes and costs associated with access/exposure to PTCs. Findings will inform international intervention and policy initiatives to improve outcomes for young people with cancer.
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Affiliation(s)
- Rachel M Taylor
- Cancer Clinical Trials, University College Hospitals NHS Foundation Trust, London, UK
| | - Lorna A Fern
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Julie Barber
- Department of Statistical Science, University College London, London, UK
| | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cádiz, Spain
| | | | - Stephen Morris
- Department of Applied Health Research, University College London, London, UK
| | - Louise Hooker
- Wessex Teenage and Young Adult Cancer Service, University Hospital Southhamptom, Southampton, UK
| | - Martin G McCabe
- Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - Faith Gibson
- ORCHID, Great Ormond Street Hospital For Children NHS Trust, London, UK
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Rosalind Raine
- Institute of Epidemiology & Health, University College London, London, UK
| | - Dan P Stark
- Leeds Insitute of Molecular Medicine, University of Leeds, Leeds, UK
| | - Jeremy S Whelan
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK
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Trama A, Bernasconi A, McCabe MG, Guevara M, Gatta G, Botta L, Ries L, Bleyer A. Is the cancer survival improvement in European and American adolescent and young adults still lagging behind that in children? Pediatr Blood Cancer 2019; 66:e27407. [PMID: 30124231 DOI: 10.1002/pbc.27407] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 01/23/2023]
Abstract
Improvements during 1978 to 2006 in the 5-year survival rate of adolescents and young adults (AYAs, age 15-39) and children with cancers common to both age groups were evaluated for 1978 to 2006 in Europe and the USA. AYAs had absolute survival increases of 25% and 15% in Europe and the USA, respectively, but in both cases, AYA 5-year survival was, as of 2006, 4% lower than those in children. Acute lymphoblastic leukemia (ALL) explained most of the survival difference between AYAs and children on both the continents. In the USA, 20- to 39-year-olds with ALL have had less survival improvement than those in Europe.
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Affiliation(s)
- Annalisa Trama
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Alice Bernasconi
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Martin G McCabe
- Institute of Cancer Sciences, University of Manchester, Manchester, UK
| | - Marcela Guevara
- Public Health Institute of Navarra, IdiSNA, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Gatta
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Laura Botta
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
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- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | | | - Archie Bleyer
- Oregon Health and Science University, Portland, Oregon.,University of Texas Medical School at Houston, Houston, Texas
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Stark D, Fern LA, Gibson F, Hawkins M, Hough R, McCabe MG, Taylor R. Transitioning adolescent and young adult cancer care research out of its adolescence. Eur J Cancer Care (Engl) 2018; 27:e12962. [DOI: 10.1111/ecc.12962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Dan Stark
- Department of Cancer Medicine; Leeds UK
- UK NCRI clinical studies group in Teenagers and Young Adults with cancer and Germ Cell Tumours; London UK
| | - Lorna A. Fern
- National Cancer Research Institute Teenage, Young Adult and Germ Cell Clinical Studies Group, Cancer Division; University College London Hospitals NHS Foundation Trust; London UK
| | - Faith Gibson
- Child Health and Cancer Care; Great Ormond Street Hospital for Children NHS Foundation Trust and University of Surrey; London UK
| | - Mike Hawkins
- Centre for Childhood Cancer Survivor Studies; University of Birmingham; Birmingham UK
| | - Rachael Hough
- Haematology and Haemopoietic Stem Cell Transplantation; UCL, London UK
- University College London Hospital’s NHS Foundation Trust; London UK
- NHS England Clinical Reference Group for Children and Young People with Cancer; London UK
| | - Martin G. McCabe
- Manchester Academic Health Science Centre; University of Manchester; Manchester UK
| | - Rachel Taylor
- Cancer Clinical Trials Unit; CNMR, University College London Hospitals NHS Foundation Trust; London UK
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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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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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36
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Courtenay M, Lim R, Castro-Sanchez E, Deslandes R, Hodson K, Morris G, Reeves S, Weiss M, Ashiru-Oredope D, Bain H, Black A, Bosanquet J, Cockburn A, Duggan C, Fitzpatrick M, Gallagher R, Grant D, McEwen J, Reid N, Sneddon J, Stewart D, Tonna A, White P. Development of consensus-based national antimicrobial stewardship competencies for UK undergraduate healthcare professional education. J Hosp Infect 2018; 100:245-256. [PMID: 29966757 DOI: 10.1016/j.jhin.2018.06.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 06/25/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Healthcare professionals are involved in an array of patient- and medicine-related stewardship activities, for which an understanding and engagement with antimicrobial stewardship (AMS) is important. Undergraduate education provides an ideal opportunity to prepare healthcare professionals for these roles and activities. AIM To provide UK national consensus on a common set of antimicrobial stewardship competencies appropriate for undergraduate healthcare professional education. METHODS A modified Delphi approach comprising two online surveys delivered to a UK national panel of 21 individuals reflecting expertise in prescribing and medicines management with regards to the education and practice of nurses and midwives, pharmacists, physiotherapists, and podiatrists; and antimicrobial prescribing and stewardship. Data collection took place between October and December 2017. FINDINGS A total of 21 participants agreed to become members of the expert panel, of whom 19 (90%) completed round 1 questionnaire, and 17 (89%) completed round 2. Panelists reached a consensus, with consistently high levels of agreement reached, on six overarching competency statements (subdivided into six domains), and 55 individual descriptors essential for antimicrobial stewardship by healthcare professionals. CONCLUSION Due to the consistently high levels of agreement reached on competency statements and their associated descriptors, this competency framework should be used to direct education for undergraduate healthcare professionals, and those working in new clinical roles to support healthcare delivery where an understanding of, and engagement with, AMS is important. Although the competencies target basic education, they can also be used for continuing education.
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Affiliation(s)
- M Courtenay
- School of Health Sciences, Cardiff University, Cardiff, UK.
| | - R Lim
- Reading School of Pharmacy, Reading University, Reading, UK
| | - E Castro-Sanchez
- NIHR Health Protection Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, London, UK
| | - R Deslandes
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - K Hodson
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - G Morris
- School of Health Sciences, Cardiff University, Cardiff, UK; Hywel Dda University Health Board, Carmarthen, UK
| | - S Reeves
- Faculty of Health, Social Care and Education, Kingston & St George's, University of London, London, UK
| | - M Weiss
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - D Ashiru-Oredope
- Antimicrobial Resistance Programme Public Health England, London, UK
| | - H Bain
- School of Nursing and Midwifery, Robert Gordon University, Aberdeen, UK
| | - A Black
- Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - J Bosanquet
- Antimicrobial Resistance Programme Public Health England, London, UK
| | - A Cockburn
- Regional Infectious Diseases Unit, Western General Hospital, Edinburgh, UK
| | - C Duggan
- Royal Pharmaceutical Society, London, UK
| | | | | | - D Grant
- Reading School of Pharmacy, Reading University, Reading, UK
| | | | - N Reid
- Public Health Wales, Cardiff, UK
| | - J Sneddon
- Healthcare Improvement Scotland, Glasgow, UK
| | - D Stewart
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK
| | - A Tonna
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK
| | - P White
- Chartered Society of Physiotherapy, London, UK
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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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38
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Courtenay M, Franklin P, Griffiths M, Hall T, Macangus J, Myers J, Peniston-Bird F, Radley K. Establishing priorities on the range of conditions managed by UK community practitioner nurse prescribers: A modified Delphi consensus study. J Adv Nurs 2018; 74:1863-1874. [PMID: 29633337 DOI: 10.1111/jan.13584] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2018] [Indexed: 12/01/2022]
Abstract
AIM To provide national consensus on the range of conditions community practitioner nurse prescribers manage and for which it is considered important that they can prescribe. BACKGROUND Around 35,000 community practitioner nurse prescribers in the United Kingdom are able to prescribe from a limited formulary. Although prescribing is a key role for these nurses, there has been a decline in the numbers of community practitioner nurse prescribers who prescribe. It is evident that changing patterns of client and service delivery, changes the role of community nurses and the conditions they manage, however, little is known about the conditions community practitioner nurse prescribers manage. DESIGN AND METHODS A modified Delphi approach comprising three on-line surveys delivered to a national Expert Panel of 89 qualified community practitioner prescribers. Data collection took place between January-March 2017. RESULTS Panelists reached a consensus, with consistent high levels of agreement reached, on nineteen conditions for which it is believed community practitioner nurse prescribers should be able to prescribe. Conditions identified by school nurses (N = 12) and health visitors (N = 7) were mainly acutely focused, whereas those identified by district nurses (N = 9) and community staff nurses (N = 6) included both long-term and acute conditions. CONCLUSION Given the high degree of consensus, this list of conditions should influence any decisions about the items community and public health nurses should be able to prescribe. The findings should also influence the education and training of these nurses.
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Affiliation(s)
- Molly Courtenay
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | | | - Matt Griffiths
- Doctors Urgent Care, Accident & Emergency Department, Urgent Care Centre, The Royal United Hospital, Bath, UK
| | | | - Julie Macangus
- Bridgewater Community Healthcare NHS Foundation Trust, Warrington, UK
| | | | - Fiona Peniston-Bird
- Medway School of Pharmacy, University of Kent and University of Greenwich, Chatham, UK
| | - Kathy Radley
- University of Hertfordshire and East and North Hertfordshire NHS Trust, Hatfield, UK
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Gaspar N, Marshall LV, Binner D, Herold R, Rousseau R, Blanc P, Capdeville R, Carleer J, Copland C, Kerloeguen Y, Norga K, Pacaud L, Sevaux MA, Spadoni C, Sterba J, Ligas F, Taube T, Uttenreuther-Fischer M, Chioato S, O'Connell MA, Geoerger B, Blay JY, Soria JC, Kaye S, Wulff B, Brugières L, Vassal G, Pearson ADJ. Joint adolescent-adult early phase clinical trials to improve access to new drugs for adolescents with cancer: proposals from the multi-stakeholder platform-ACCELERATE. Ann Oncol 2018; 29:766-771. [PMID: 29351570 PMCID: PMC5889024 DOI: 10.1093/annonc/mdy002] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- N Gaspar
- Department of Oncology for Children and Adolescents, Gustave Roussy Cancer Campus, Villejuif, France.
| | - L V Marshall
- Paediatric and Adolescent Drug Development Team, Oak Centre for Children & Young People, The Royal Marsden Hospital & The Institute of Cancer Research, London, UK
| | - D Binner
- Create for Chloe and UK Representative for aPODD, European Medicines Agency, London, UK
| | - R Herold
- Product Development Scientific Support Department, European Medicines Agency, London, UK
| | - R Rousseau
- Gritstone Oncology, Inc., Emeryville, USA
| | - P Blanc
- Imagine for Margo, Fourqueux, France
| | | | - J Carleer
- Belgium Federal Agency for Medicines and Health Products, EUROSTATION, Brussels, Belgium
| | - C Copland
- Centre for English Language Teaching, University of York, York, UK
| | - Y Kerloeguen
- Pharmaceuticals Division, PDOA, Oncology, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - K Norga
- Paediatric and Adolescent Drug Development Team, Oak Centre for Children & Young People, The Royal Marsden Hospital & The Institute of Cancer Research, London, UK; Universitair Ziekenhuis Antwerpen, Edegem, Belgium
| | | | | | - C Spadoni
- aPODD Foundation, City Point, London, UK
| | - J Sterba
- Pediatric Oncology Department, University Hospital Brno, School of Medicine Masaryk University Brno, Regional Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, ICRC Brno, St. Anna University Hospital Brno, Czech Republic
| | - F Ligas
- Product Development Scientific Support Department, European Medicines Agency, London, UK
| | - T Taube
- Boehringer Ingelheim, Pharma GmbH&Co KG, TA Oncology, Biberach, Germany
| | | | - S Chioato
- Regulatory Strategy Oncology, Pfizer Italia, Milano, Italy
| | - M A O'Connell
- Regulatory Strategy Oncology, Pfizer Italia, Milano, Italy
| | - B Geoerger
- Department of Oncology for Children and Adolescents, Gustave Roussy Cancer Campus, Villejuif, France
| | - J-Y Blay
- Centre Léon Bérard and University Claude Bernard Lyon 1, Lyon
| | - J C Soria
- Drug Development Department (DITEP), Gustave Roussy, Villejuif and University Paris-Sud, Orsay, France
| | - S Kaye
- Adult Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, London, UK
| | - B Wulff
- Paediatric Haematology/Oncology, Clinical Research/Paediatric Drug Development, University Childreńs Hospital III Hufelandstraße, Essen, Germany
| | - L Brugières
- Department of Oncology for Children and Adolescents, Gustave Roussy Cancer Campus, Villejuif, France
| | - G Vassal
- Department of Clinical Research, Gustave Roussy, Villejuif and Paris-Sud University, Le Kremlin-Bicêtre, France
| | - A D J Pearson
- Paediatric and Adolescent Drug Development Team, Oak Centre for Children & Young People, The Royal Marsden Hospital & The Institute of Cancer Research, London, UK
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40
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Zapotocky M, Ramaswamy V, Lassaletta A, Bouffet E. Adolescents and young adults with brain tumors in the context of molecular advances in neuro-oncology. Pediatr Blood Cancer 2018; 65. [PMID: 29049858 DOI: 10.1002/pbc.26861] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 09/21/2017] [Accepted: 09/22/2017] [Indexed: 12/26/2022]
Abstract
Adolescents and young adults (AYA) comprise a specific group of oncology patients with a distinct biological and epidemiological spectrum of central nervous system neoplasms. It has been well documented that they differ clinically, especially in relation to prognosis and chemotherapy tolerance; however, the underlying reasons for this are unclear. Recent advances in the genomics of both childhood and adult brain tumors have provided new explanations and insights into the previously described age-dependent heterogeneity. Herein, we summarize the current state of the AYA population in neuro-oncology, specifically how biological advances can help personalize therapy for this unique group of patients.
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Affiliation(s)
- Michal Zapotocky
- Department of Pediatric Hematology and Oncology, University Hospital Motol and 2nd Medical School, Charles University, Prague, Czech Republic.,Division of Hematology/Oncology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Vijay Ramaswamy
- Division of Hematology/Oncology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Alvaro Lassaletta
- Pediatric Hematology Oncology Department, Hospital Niño Jesús, Madrid, Spain
| | - Eric Bouffet
- Division of Hematology/Oncology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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41
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Kaal SE, Husson O, van Dartel F, Hermans K, Jansen R, Manten-Horst E, Servaes P, van de Belt TH, Engelen LJ, Prins JB, Verberne S, van der Graaf WT. Online support community for adolescents and young adults (AYAs) with cancer: user statistics, evaluation, and content analysis. Patient Prefer Adherence 2018; 12:2615-2622. [PMID: 30584285 PMCID: PMC6287522 DOI: 10.2147/ppa.s171892] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Peer support is an important unmet need among adolescent and young adult (AYA) cancer patients. This study was conducted to describe the use and evaluation of a Dutch secure online support community for AYA diagnosed with cancer between 18 and 35 years. METHODS User statistics were collected with Google analytics. Community members were asked to complete questionnaires on the usefulness of the community. A content analysis using Linguistic Inquiry and Word Count was conducted. RESULTS Between 2010 and 2017, the community received 433 AYA members (71% female; mean age at diagnosis 25.7 years; 52 Dutch hospitals represented). The mean time since diagnosis when subscribing to the community was 2.7 years (SD 4.4). Questionnaire data among 30 AYA community members indicated that the use of the community resulted in acknowledgment and advice regarding problems (56%) and the feeling of being supported (63%). Almost half of the respondents felt less lonely, 78% experienced recognition in stories of other AYA. Anonymized content analysis (n=14) showed that the majority of the online discussions encompassed emotional and cognitive expressions, and emotional support. CONCLUSION The secure Dutch online AYA community can help AYA cancer patients to express feelings, exchange information, address peer support, and has been found helpful in coping with cancer. As AYA cancer patients often lack the option of meeting each other in person, the AYA community is helpful in establishing peer support. Its use would benefit from promotion by health care professionals.
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Affiliation(s)
- Suzanne Ej Kaal
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands,
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
| | - Olga Husson
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
- Division of Clinical Studies, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK,
| | - Fleur van Dartel
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Karin Hermans
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands,
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
| | - Rosemarie Jansen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands,
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
| | - Eveliene Manten-Horst
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands,
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
| | - Petra Servaes
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Tom H van de Belt
- Radboud REshape and Innovation Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lucien Jlpg Engelen
- Radboud REshape and Innovation Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Judith B Prins
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Suzan Verberne
- Leiden Institute for Advanced Computer Science, Leiden University, Leiden, the Netherlands
| | - Winette Ta van der Graaf
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands,
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
- Division of Clinical Studies, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK,
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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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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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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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45
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Escherich G, Bielack S, Maier S, Braungart R, Brümmendorf TH, Freund M, Grosse R, Hoferer A, Kampschulte R, Koch B, Lauten M, Milani V, Ross H, Schilling F, Wöhrle D, Cario H, Dirksen U. Building a National Framework for Adolescent and Young Adult Hematology and Oncology and Transition from Pediatric to Adult Care: Report of the Inaugural Meeting of the “AjET” Working Group of the German Society for Pediatric Oncology and Hematology. J Adolesc Young Adult Oncol 2017; 6:194-199. [DOI: 10.1089/jayao.2016.0075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Gabriele Escherich
- University Medical Centre Eppendorf, Clinic of Pediatric Hematology and Oncology, Hamburg, Germany
| | - Stefan Bielack
- Pediatrics 5 (Oncology, Hematology, Immunology), Klinikum Stuttgart—Olgahospital, Stuttgart Cancer Center, Stuttgart, Germany
| | - Stephan Maier
- Katharinenhöhe, Rehabilitationsklinik GmbH, Schönwald, Germany
| | - Ralf Braungart
- Pediatrics 5 (Oncology, Hematology, Immunology), Klinikum Stuttgart—Olgahospital, Stuttgart Cancer Center, Stuttgart, Germany
| | - Tim H. Brümmendorf
- Department of Hematology and Oncology, University Hospital of the RWTH Aachen, Aachen, Germany
| | - Mathias Freund
- Deutsche Stiftung für Junge Erwachsene mit Krebs, Berlin, Germany
| | - Regine Grosse
- University Medical Centre Eppendorf, Clinic of Pediatric Hematology and Oncology, Hamburg, Germany
| | - Anette Hoferer
- Haematology/Oncology Department for Adolescent Medicine, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Rebecca Kampschulte
- Netzwerk für die Versorgung Schwerkranker Kinder und Jugendlicher e.V., Department of Paediatric Haematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Barbara Koch
- University Medical Centre Eppendorf, Clinic of Pediatric Hematology and Oncology, Hamburg, Germany
| | - Melchior Lauten
- Department of Pediatrics, University Hospital Schleswig-Holstein, University of Lübeck, Lübeck, Germany
| | - Valeria Milani
- MVZ Facharztzentrum Fürstenfeldbruck, Fürstenfeldbruck, Germany
| | - Henning Ross
- Katharinenhöhe, Rehabilitationsklinik GmbH, Schönwald, Germany
| | - Freimut Schilling
- Pediatrics 5 (Oncology, Hematology, Immunology), Klinikum Stuttgart—Olgahospital, Stuttgart Cancer Center, Stuttgart, Germany
| | - Dieter Wöhrle
- Jugend & Zukunft Berufliche Beratung für Junge Menschen mit Krebserkrankung, München, Germany
| | - Holger Cario
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Uta Dirksen
- University Hospital Muenster, Westfalian Wilhelms University Muenster, Muenster, Germany
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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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Gibson F, Pearce S, Fern L, Martins A, Kelly D. Improving the identification of cancer in young people: A scoping review. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/23809000.2017.1307089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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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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49
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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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Jones LJ, Pini SA, Morgan SJ, Birk GK, Stark DP. How Do Teenagers and Young Adults with Cancer Experience Their Care? A European Survey. J Adolesc Young Adult Oncol 2017; 6:102-110. [DOI: 10.1089/jayao.2016.0011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Lucy J.W. Jones
- Leeds Teaching Hospital Trust, St. James's Institute of Oncology, Leeds, United Kingdom
| | - Simon A. Pini
- The Psychosocial Research Group, University of Leeds, Leeds, United Kingdom
| | - Sue J. Morgan
- Leeds Teaching Hospital Trust, St. James's Institute of Oncology, Leeds, United Kingdom
| | - Gurpreet K. Birk
- Leeds Teaching Hospital Trust, St. James's Institute of Oncology, Leeds, United Kingdom
| | - Dan P. Stark
- Leeds Teaching Hospital Trust, St. James's Institute of Oncology, Leeds, United Kingdom
- The Psychosocial Research Group, University of Leeds, Leeds, United Kingdom
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