Problems during the long-term follow-up after surgery for pediatric solid malignancies

Area of Science:

• Pediatric Oncology
• Surgical Oncology
• Long-term Survivorship

Background:

• Increasing survival rates for pediatric malignancies necessitate understanding long-term treatment sequelae.
• Late effects of cancer treatments, particularly after surgery, are critical issues for childhood cancer survivors.

Purpose of the Study:

• To analyze the spectrum of problems encountered during the long-term follow-up of pediatric patients treated surgically for cancer.
• To identify specific complications and their correlation with treatment modalities, including high-dose chemotherapy (HDC) and radiotherapy.

Main Methods:

• Retrospective analysis of 64 pediatric cancer patients with >5 years follow-up post-surgery.
• Patients were over 13 years old at the time of follow-up, with a mean follow-up of 17.7 years.
• Data collected on surgical complications, medical issues, and treatment exposures like high-dose chemotherapy (HDC) and radiotherapy.

Main Results:

• 71.9% of patients experienced at least one complication; medical issues were more prevalent than surgical ones.
• Common medical problems included growth retardation (15 patients), gonadal dysfunction (23 patients), and hypothyroidism (6 patients).
• High-dose chemotherapy (HDC) was significantly associated with higher rates of growth retardation, gonadal dysfunction, and hypothyroidism (p<0.05).

Conclusions:

• Late treatment-related complications, especially endocrine disorders, are common and can manifest years after therapy, particularly following HDC.
• Medical problems, notably endocrine disorders, pose a greater long-term challenge than surgical complications.
• Lifelong medical surveillance involving a multidisciplinary team is essential for managing these late effects in pediatric cancer survivors.