Late recurrence of Ewing sarcomas and astrocytomas: A risk for some pediatric cancers

Late recurrence is a risk for some pediatric cancers, particularly Ewing sarcomas and tumors of the central nervous system, according to a new study published online December 4 in the Journal of the National Cancer Institute.

This study was undertaken because there is limited research on late recurrence (after 5 years and up to 20 years) for pediatric cancer patients.

Karen Wasilewski-Masker, M.D., of the Aflac Cancer Center and Blood Disorders Service, Children's Healthcare of Atlanta at Scottish Rite, and colleagues analyzed data from the Childhood Cancer Survivor Study for 12,795 five-year survivors of the most common pediatric cancers. Cumulative incidence of late recurrence at 5, 10, 15, and 20 years after diagnosis was calculated using death as a competing risk.

The overall pediatric cancer recurrence rate was 4.4% at 10 years and 6.2% at 20 years among 5-year survivors. Thirteen percent of Ewing sarcomas and 14.4% of astrocytomas had recurred by 20 years. Only 0.9% of pediatric kidney tumors, 2.4% of Non-Hodgkin lymphomas, and 2.6% of neuroblastomas had recurred in 5 year-survivors by 20 years after treatment.

"Future research is needed to determine the risk of recurrence in subgroups of survivors and the cost-effectiveness of long-term disease surveillance in at-risk patient groups because these factors need to be considered in long-term follow-up and transitional care plans," the authors write.