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Chronic medical conditions in adult survivors of retinoblastoma: Results of the Retinoblastoma Survivor Study
Author(s) -
Friedman Danielle Novetsky,
Chou Joanne F.,
Oeffinger Kevin C.,
Kleinerman Ruth A.,
Ford Jennifer S.,
Sklar Charles A.,
Li Yuelin,
McCabe Mary S.,
Robison Leslie L.,
Marr Brian P.,
Abramson David H.,
Dunkel Ira J.
Publication year - 2016
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.29704
Subject(s) - medicine , retinoblastoma , oncology , pediatrics , genetics , gene , biology
BACKGROUND Limited data are available regarding long‐term morbidity in adult survivors of retinoblastoma (Rb). METHODS The Retinoblastoma Survivor Study is a retrospective cohort of adult survivors of Rb diagnosed between 1932 and 1994. Participants completed a comprehensive questionnaire adapted from the Childhood Cancer Survivor Study surveys. Chronic conditions were classified using the National Cancer Institute's Common Terminology Criteria for Adverse Events (version 4.03). Multivariate Poisson regression was used to compare survivors of Rb with 2377 non‐Rb controls, consisting of the Childhood Cancer Survivor Study sibling cohort and survivors with bilateral versus unilateral disease. RESULTS Survivors of Rb (53.6% with bilateral disease) and non‐Rb controls had a mean age of 43.3 years (standard deviation, 11 years) and 37.6 years (SD, 8.6 years), respectively, at the time of study enrollment. At a median follow‐up of 42 years (range, 15‐75 years), 86.6% of survivors of Rb had at least 1 condition and 71.1% had a severe/life‐threatening (grade 3‐4) condition. The adjusted relative risk (RR) of a chronic condition in survivors compared with non‐Rb controls was 1.4 (95% confidence interval [95% CI], 1.3‐1.4; P <.01); for a grade 3 to 4 condition, the RR was 7.6 (95% CI, 6.4‐8.9; P <.01). Survivors were at an excess risk regardless of laterality. After stratifying by laterality and excluding ocular conditions and second malignant neoplasms (SMNs), only those with bilateral disease were found to be at an increased risk of any nonocular, non‐SMN condition (RR, 1.2; 95% CI, 1.1‐1.2) and for grade 3 to 4 nonocular, non‐SMN conditions (RR, 1.7; 95% CI, 1.2‐2.5). CONCLUSIONS Survivors of Rb have an increased risk of chronic conditions compared with non‐Rb controls. After excluding ocular conditions and SMNs, this excess risk was found to persist only for those with bilateral disease. Cancer 2016;122:773–781. © 2016 American Cancer Society .