Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India

LATEST ARTICLES
SEARCH INDEX
SUGGEST ARTICLE
THE OSI COLLECTIONS
AUDIOGRAM SERIES
ABOUT THE OSI
2020 SUMMARY
2021 SUMMARY

OSI STATISTICS

Open access articles:
1592
Annotations added:
3
Countries represented:
117
No. of contributors:
15
Bookmarks made:
26

Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India


JournalJCO Global Oncology
Article typeJournal research article – Clinical research
Publication date – Nov – 2022
Authors – Maya Prasad, Savita Goswami, Girish Chinnaswamy, Shripad D. Banavali,Purna A. Kurkure
Keywordschildhood cancer (CCS), India, Low-and middle-income countries, neurocognitive
Open access – Yes
SpecialityPaediatric surgery, Surgical oncology
World region Southern Asia
Country: India
Language – English
Submitted to the One Surgery Index on November 28, 2022 at 8:25 am
Abstract:

PURPOSE
Despite an increasing number of survivors of childhood cancer (CCS) in low- and middle-income countries, survivorship care is in its nascent stages. We describe the spectrum of late effects seen, challenges faced, and lessons learnt over three decades of a late effects program in India.

METHODS
We describe the demographics and profile of late effects of all CCS survivors enrolled in our After Completion of Treatment Clinic from February 5, 1991 (inception) to February 4, 2021. We analyzed the trends by the decade of diagnosis.

RESULTS
There were 3,067 CCS survivors, the median age was 18 years (range, 3-57 years), and the median follow-up was 11 years (range, 2-46 years). Two thirds (62.4%) had either no or mild late effects, 480 (15.6%), 497 (16.2%), and 162 (5.3%) had grades 2, 3, and 4 late effects, with 67 deaths reported. Notable late effects were chronic viral hepatitis (7.8%), thyroid dysfunction (7.5%), other endocrine issues (13.6%), psychosocial issues (57%), neurocognitive impairment (4.1%), and metabolic syndrome (4%). The cumulative incidence and severity of late effects showed a consistent decline by the decade of diagnosis. Twenty-two percent of survivors are lost to follow-up.

CONCLUSION
Survivors of childhood cancer treated on contemporary treatment protocols have a significantly lower side-effect profile. Attrition to long-term follow-up and psychosocial issues are significant concerns. Understanding the unique spectrum of late effects and establishing a holistic support system go a long way in ensuring the long-term physical and mental health and psychosocial concerns of childhood cancer survivors in low- and middle-income countries.

OSI Number – 21827

Public annotations on this article:
No public annotations yet