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Detection of recurrence in childhood solid tumors
Lisa Howell1, Adjoa Mensah, Bernadette Brennan
1Department of Pediatric Oncology, Royal Manchester Children's Hospital, Pendlebury, Manchester, United Kingdom.
Cancer
|January 28, 2005
Summary
Frequent follow-up in pediatric oncology may not effectively detect recurrent solid tumors. Most recurrences were found symptomatically, questioning the value of routine investigations and clinic visits for early detection.
Area of Science:
- Pediatric Oncology
- Clinical Research
- Cancer Recurrence
Background:
- Routine follow-up and investigations are standard in pediatric oncology.
- Limited evidence exists on the effectiveness of these practices for detecting recurrent disease.
Purpose of the Study:
- To evaluate the value of frequent follow-up and routine investigations in detecting recurrent solid tumors in children.
- To analyze the modes of recurrence detection in a cohort of pediatric cancer patients.
Main Methods:
- Retrospective study of 186 children with solid tumors diagnosed between 1992 and 1996.
- Recorded numbers of clinic visits, follow-up investigations, and methods of recurrence detection.
- Calculated recurrence detection rates for specific imaging modalities.
Main Results:
- 37 recurrences detected over a mean follow-up of 5.9 years.
- Symptomatic detection occurred in 54% of patients, routine investigation in 30%, and routine clinic appointments in 16%.
- Routine MRI detected 1 recurrence per 42 scans; CT, 1 per 129 scans; radiography, 1 per 257 films.
Conclusions:
- Current follow-up strategies raise questions about their utility in detecting recurrent solid tumors in pediatric patients.
- Findings suggest a need to re-evaluate the necessity and effectiveness of intensive follow-up protocols.
