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Neuroblastoma With Intraspinal Extension: Health Problems in Long‐Term Survivors
Author(s) -
Kraal Kathelijne,
Blom Thomas,
Tytgat Lieve,
Santen Hanneke,
Noesel Max,
Smets Anne,
Bramer Jos,
Caron Huib,
Kremer Leontien,
der Pal Heleen
Publication year - 2016
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.25925
Subject(s) - medicine , pediatrics , kyphosis , scoliosis , laminectomy , cohort , medical record , retrospective cohort study , surgery , survivorship curve , cancer , radiography , spinal cord , psychiatry
Aim To evaluate the prevalence of health problems in 5‐year survivors treated for neuroblastoma (NBL) with intraspinal extension. Patients and Methods Retrospective, single center cohort study (using data from Childhood Cancer Registry and medical records) of patients treated for NBL with intraspinal extension (between 1980 and 2007) who survived ≥ 5 years after diagnosis. Health problems were graded according to the Common Terminology Criteria for Adverse Events (CTCAEv.3.0). Results All eligible patients (n = 19) were included (n = 7 no neurological symptoms at diagnosis), median age at diagnosis was 1.2 years (0.6–10.8 years), and median follow‐up time was 15.6 years (6.3–29.5 years). Ninety‐five percent of survivors had ≥1 health problem and 48% of survivors had ≥4 health problem with a mean of 3.8 per survivor. Fifty‐three percent of survivors had at least one severe (grade 3) or life‐threatening/disabling (grade 4) health problem. The three most prevalent health problems were kyphosis and/or scoliosis (68% of patients), motor neuropathy (32% of patients), and sensory neuropathy (26% of patients). Of the 13 patients who underwent a laminectomy, 54% (seven of 13) developed a grade 3 and 23% (three of 13) developed a grade 4 health problem. Among six patients, without laminectomy, 17% developed (one of six) a grade 3 and in 17% developed (one of six) a grade 4 health problem. Conclusions Ninety‐five percent of 5‐year survivors treated for a childhood intraspinal NBL have health problems. The high prevalence of grade 3 and 4 health problems (especially in the laminectomy group) emphasizes the importance of specialized long‐term multidisciplinary follow‐up and identifies optimal treatment with limited morbidity and maximal efficacy.