Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.
Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.
Pediatr Blood Cancer. 2021 May;68(5):e28905. doi: 10.1002/pbc.28905. Epub 2021 Jan 23.
With modern therapy, over 90% of Wilms tumor patients can expect to become long-term survivors, and focus on morbidity and late effects become increasingly important. We provide a novel evaluation and insight to subsequent hospitalizations in 5-year survivors of Wilms tumor.
As part of the Adult Life after Childhood Cancer in Scandinavia (ALiCCS) study, we identified 5-year survivors of Wilms tumor. Based on stratified random sampling, we constructed a population comparison cohort. Outcomes of interest were overall hospitalizations; hospitalizations for specific organ systems and disease-specific categories. Standardized hospitalization rate ratios (SHRR) and absolute excess risks (AER) were calculated.
We included 913, 5-year survivors of Wilms tumor and 152 231 population comparisons. Survivors of Wilms tumor had an increased overall risk of being hospitalized (SHRR 1.8; 95% confidence interval (CI) 1.7-2.0). The hospitalization risk was increased within all major organ systems: urinary and genital organs (SHRR 2.5; 95% CI 2.1-3.0), endocrine (SHRR 2.5; 95% CI 1.9-3.3), cardiovascular (SHRR 2.2; 95% CI 1.7-2.9), and gastrointestinal (SHRR 1.5; 95% CI 1.3-1.8). Risks for specific diseases are reported in the study.
Survivors of Wilms tumor had higher risks than population comparisons for a wide range of diseases, with the highest risks seen for urinary, endocrine, and cardiovascular disorders. Five to 20 years after the Wilms tumor diagnosis, 43% of survivors had been hospitalized at least once versus 29% of population comparisons. The overall AER was 2.3, which translates into 0.2 extra hospitalizations in 10 years for every Wilms tumor survivor.
随着现代疗法的应用，超过 90%的肾母细胞瘤患者有望成为长期幸存者，发病率和晚期效应越来越受到关注。我们对肾母细胞瘤 5 年幸存者的后续住院情况进行了评估和深入研究。
作为北欧儿童癌症生存者成人生活（ALiCCS）研究的一部分，我们确定了肾母细胞瘤的 5 年幸存者。基于分层随机抽样，我们构建了一个人群对照组。感兴趣的结果是总住院人数；特定器官系统和疾病特异性类别的住院人数。计算了标准化住院率比（SHRR）和绝对超额风险（AER）。
我们纳入了 913 例肾母细胞瘤 5 年幸存者和 152 231 名人群对照者。肾母细胞瘤幸存者的总住院风险增加（SHRR 1.8；95%置信区间[CI] 1.7-2.0）。所有主要器官系统的住院风险均增加：泌尿生殖系统（SHRR 2.5；95%CI 2.1-3.0）、内分泌系统（SHRR 2.5；95%CI 1.9-3.3）、心血管系统（SHRR 2.2；95%CI 1.7-2.9）和胃肠道系统（SHRR 1.5；95%CI 1.3-1.8）。研究中报告了特定疾病的风险。
与人群对照组相比，肾母细胞瘤幸存者患多种疾病的风险更高，其中泌尿、内分泌和心血管疾病的风险最高。在肾母细胞瘤诊断后 5 至 20 年，43%的幸存者至少住院一次，而人群对照组的这一比例为 29%。总体 AER 为 2.3，这意味着每 10 年每 10 名肾母细胞瘤幸存者就会额外增加 0.2 次住院。
