Survivors of childhood cancer have an increased risk of subsequent renal cancers compared to the general population, researchers reported in the Journal of the National Cancer Institute. The risk is particularly high among survivors of neuroblastoma and those who have had irradiation involving the kidneys.
The researchers estimated standardized incidence ratios for subsequent renal carcinoma among the 14,358 survivors enrolled in the Childhood Cancer Survivor Study, which includes survivors who were treated at 26 institutions in the United States and Canada between 1970 and 1986. Among the 26 survivors diagnosed with a subsequent renal carcinoma, the median time to diagnosis was 22.6 years (range, 6.3–35.7 years).
“Survivors were more likely to develop renal carcinoma than the general population” (standardized incidence ratio = 8.0, 95% CI = 5.2–11.7), the authors reported, as were survivors of neuroblastoma (8 cases among 954 survivors, standardized incidence ratio = 85.8, 95% CI = 38.4–175.2). “The overall absolute excess risk was 8.4 per 105 person-years,” they wrote.
Multivariate analysis showed that “increased risk was associated with renal-directed radiotherapy of 5 Gy or greater (relative risk [RR] = 3.8, 95% CI = 1.6–9.3) and cisplatin exposure (RR = 3.5, 95% CI = 1.0–11.2),” the researchers reported. “To our knowledge,” they stated, “this is the first report of an association between cisplatin and subsequent renal carcinoma among survivors of childhood cancer.” ■
Wilson CL, et al: J Natl Cancer Inst 105;504-508, 2013.