Long-term follow-up for childhood cancer survivors: the Geneva experience

Article Article scientifique Article Long-term follow-up for childhood cancer survivors: the Geneva experience eng 2022-04-07 2022-03-28 author Babecoff Shai 820576 author Mermillod Florence 822590 author Marino Denis 649455 author Gayet-Ageron Angèle 668551 author Ansari Djaberi Marc Georges 61572 author Fernandez Eugenio 509936 author Gumy Pause Fabienne 0000-0002-2835-4367 133418 w30153 10.4414/smw.2022.w30153 35429234 1424-3997 https://smw.ch/index.php/smw/article/view/3181 Aims of the study: Although the 5-year survival for pediatric cancer in Switzerland today is over 85%, two thirds of the survivors will develop chronic health conditions due to the disease or to the toxicity of treatments. In this context, a long-term personalized follow-up program (LTFU program), was set up at the University Hospitals of Geneva (HUG) since 2015. We aimed to describe this program, more particularly the specialized follow-ups set up, the cumulative burden of the chronic health conditions, and finally assess the satisfaction of patients and/or their parents with it. Methods: A monocentric retrospective study was performed where data on follow-ups and chronic health conditions were collected from medical charts of people who had childhood cancer and who participated in the LTFU program. Chronic health conditions were classified and graded in severity with the Common Terminology Criteria of Adverse Events (CTCAE) classification, version 5.0. This study was completed by a satisfaction survey among patients and/or their parents. Results: Out of 83 eligible patients, 51 (61.4%) accepted to participate, with an average age of 17.4 years (range, 10 to 35) at the time of study. Mean delay since end of treatment was 9.8 years (range: 4.5-31). The prevalence of any chronic health condition is 82.3%, 43.1% for having 1 or 2 chronic health conditions and 39.2% for having more than 3 chronic health conditions. The total number of Grade CTCAE 1-4 chronic health conditions was 118 for the 51 participants, with a mean of 2.3 (range, 0 to 7) disorders per patient. The most frequently affected systems were neurological (14.4%), musculoskeletal (13.6%), endocrine (9.3%) and renal (9.3%) systems. Sarcoma, central nervous system tumors and neuroblastoma were the diagnoses associated with the highest average number of chronic health conditions. Among the 118 questionnaires sent to patients and/or parents, we received 82 (69.5%) responses. The level of satisfaction was good to excellent for more than 90% of the participants, for all the items evaluated. Conclusions: Childhood cancer survivors present a significant number of chronic health conditions, confirming the need for appropriate long-term, multidisciplinary and patient-specific medical follow-up based on the primary diagnosis and therapies received. Moreover, the LTFU program at the HUG was highly appreciated by patients and/or their parents and this motivates its permanent conduct. Adolescent Cancer Survivors Child Chronic Disease Follow-Up Studies Humans Neoplasms / therapy Retrospective Studies Survivors Dewey 613 Dewey 616 Dewey 618 58 Département de pédiatrie, gynécologie et obstétrique 223 64 Département de santé et médecine communautaires 22A 217 Centre de recherche clinique 201 56 Département de médecine 221 false 88 Epidémiologie clinique et biostatistique 115 564 Oncologie et hématologie pédiatriques 907 Swiss medical weekly 152 e8c6e7f8-2aea-47dc-858b-ed48607878ef Article (Published version) Public SwissMedWkly_GayetAgeron_2022.pdf 4288901 application/pdf CC BY-NC-SA-4.0 openAccess Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires Faculté de médecine / Centre de recherche clinique Faculté de médecine / Section de médecine clinique / Département de médecine

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Long-term follow-up for childhood cancer survivors: the Geneva experience	Swiss medical weekly			2022	214	161

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Babecoff, Shai