Significant improvement in survival of advanced stage childhood and young adolescent cancer in the Netherlands since the 1990s

Abstract

Background: This is the first national study on trends in cancer survival and mortality for children and young adolescents in the Netherlands including unique information on stage at diagnosis. Methods: All neoplasms in patients <18 years, diagnosed between 1990 and 2015 (N Z 14,060), were derived from the Netherlands Cancer Registry. Cohort and period survival analyses were used to estimate observed survival (OS). Time trends in OS and mortality rates were evaluated by parametric survival models and average annual percentage change, respectively. Results: Between 1990 and 2015, 5-year OS and 10-year OS of childhood and young adolescent cancer have improved significantly by 9 percent points, reaching 81% and 78%, respectively. Favourable trends in survival were observed for all age groups and most diagnostic (sub)groups, being particularly pronounced for advanced disease. Non-Hodgkin lymphomas Ann Arbor stage III, metastatic neuroblastomas (age !18 months) and Ewing bone sarcomas showed significant improvements in 5-year OS. Compared with 1990e99, the risk of dying within five years of diagnosis was decreased significantly during 2000e09 (hazard ratio

Long‐term childhood cancer survival in Australia using period estimation

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Implementation of paediatric precision oncology into clinical practice: The Individualized Therapies for Children with cancer program ‘iTHER’

“…Over the last decades, survival of paediatric oncology patients in high-income countries has significantly increased due to intense multimodal treatment strategies, improved supportive care, and centralisation of paediatric oncologic care [ 1 , 2 ]. However, prognosis for a subset of patients with high-risk, relapsed, and refractory cancers remains poor, and survivors are facing severe late side-effects, stressing the need for innovative treatment approaches [ 3 ].…”

Intercalary reconstruction of long bones by massive allograft: Comparison of construct stability ensured by three different host-graft junctions and two types of fixations in a synthetic femur model

“…Increasing the size of the fixation device can significantly change the present bending and torsional stiffness values, but with an associated increased risk of stress shielding ( 47 , 48 ). Stress shielding within bone tissue at the level of the intercalary reconstruction might determine negative bone remodelling, especially when reconstruction is combined with a vascularised fibular autograft ( 49 – 51 ). From a biomechanical point of view, this study confirms the advantages of an inherent stable host-graft connection ( 52 – 54 ), i.e., an alternative way to increase the stiffness of the intercalary reconstruction can be by changing the load transfer mechanisms through different host-graft junctions.…”