Teke Kısa Pelin, Emir Suna
Department of Pediatrics, Health Science University Ankara Bilkent City Hospital, Ankara, Turkey.
Department of Pediatric Hematology Oncology, Atılım University Faculty of Medicine, Ankara, Turkey.
Turk Arch Pediatr. 2021 Jan 6;56(2):147-151. doi: 10.14744/TurkPediatriArs.2020.38243. eCollection 2021 Mar.
As the survival rates in children with cancer reach up to 80%, this improvement in survival increases the number of patients under follow-up. After cancer treatment is completed, patients are taken to follow-up surveillance to ensure the early detection of recurrence and the late effects of treatments. The frequency and necessity of surveillance screening tests are controversial. This study aimed to assess the efficacy of surveillance screening in the detection of recurrence.
The files of 533 children who were diagnosed as having cancer at our pediatric oncology clinic between 2004 and 2013 were retrospectively evaluated. We looked at outcomes after recurrence, the timing and pattern of recurrence, the presence of symptoms during recurrence, physical examination findings, tumor marker levels, laboratory findings, and radiologic tests.
Of the 63 patients with recurrence, 23 were symptomatic and 40 were asymptomatic at the time of the recurrence. Tumor location and time of the recurrence did not affect the post recurrence survival. The median post-recurrence survival for patients was 13 (range, 1-98) months. The median post-relapse survival was 10 (range, 1-73) months in patients with symptomatic recurrence, and 16 (range, 1-98) months in patients with asymptomatic recurrence. It was determined that patients in whom recurrence was identified with surveillance tests had longer post-relapse survival time. The 5-year survival rate of 23 patients with symptomatic recurrence was 12.2%; this rate was 49.5% in asymptomatic patients (p<0.05).
It should be considered that surveillance testing offers the benefit of prolonging post recurrence survival.
随着癌症患儿的生存率高达80%，生存率的提高增加了接受随访的患者数量。癌症治疗完成后，对患者进行随访监测，以确保早期发现复发及治疗的晚期效应。监测筛查试验的频率和必要性存在争议。本研究旨在评估监测筛查在检测复发方面的疗效。
回顾性评估了2004年至2013年间在我院儿科肿瘤门诊被诊断为癌症的533名儿童的病历。我们观察了复发后的结局、复发的时间和模式、复发期间的症状、体格检查结果、肿瘤标志物水平、实验室检查结果和影像学检查。
在63例复发患者中，23例在复发时有症状，40例无症状。肿瘤部位和复发时间不影响复发后的生存率。患者复发后的中位生存期为13（范围1-98）个月。有症状复发患者的复发后中位生存期为10（范围1-73）个月，无症状复发患者为16（范围1-98）个月。经监测试验发现复发的患者复发后生存期更长。23例有症状复发患者的5年生存率为12.2%；无症状患者的这一比例为49.5%（p<0.05）。
应考虑到监测试验具有延长复发后生存期的益处。
