In a Dutch study reported in the Journal of Clinical Oncology, Westerveld et al identified long-term risks of subsequent neoplasms in 5-year survivors of childhood neuroblastoma.
Study Details
The study included data from 563 survivors in the Dutch Childhood Cancer Survivor Study–LATER cohort diagnosed between 1963 and 2014.
Key Findings
Overall, a subsequent malignant neoplasm developed in 23 survivors and a subsequent nonmalignant neoplasm developed in 60. After a median follow-up of 23.7 years (range = 5.0–56.3 years), survivors had an increased risk of subsequent malignant neoplasm vs the general population (standardized incidence ratio [SIR] = 4.0, 95% confidence interval [CI] = 2.5–5.9; absolute excess risk = 15.1 cases/10,000 person-years). The 30-year cumulative incidence was 3.4% (95% CI = 1.9%-6.0%) for subsequent malignant neoplasms and 10.4% (95% CI = 7.3%–14.8%) for subsequent nonmalignant neoplasms.
Six survivors developed a subsequent malignant neoplasm after treatment with iodine-metaiodobenzylguanidine (I-131 MIBG) treatment. Compared with survivors who did not receive I-131 MIBG, those who did had an increased risk of subsequent malignant neoplasms (subdistribution hazard ratio [HR] = 5.7, 95% CI = 1.8–17.8) and subsequent nonmalignant neoplasms (subdistribution HR = 2.6, 95% CI = 1.2–5.6). Risk associated with I-131 MIBG treatment was attenuated among high-risk patients for subsequent malignant neoplasms (subdistribution HR = 3.6, 95% CI = 0.9–15.3) and subsequent nonmalignant neoplasms (subdistribution HR = 1.5, 95% CI = 0.7–3.6).
The investigators concluded: “Our results demonstrate that neuroblastoma survivors have an elevated risk of developing [subsequent malignant neoplasms] and a high risk of [subsequent nonmalignant neoplasms]. [I-131 MIBG] may be a treatment-related risk factor for the development of [subsequent malignant neoplasm] and [subsequent nonmalignant neoplasm], which needs further validation. Our results emphasize the need for awareness of subsequent neoplasms and the importance of follow-up care.”
Aimée S.R. Westerveld, MSc, of Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by the KiKa core funding of the Princess Máxima Center for Pediatric Oncology. For full disclosures of the study authors, visit ascopubs.org.
