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Long-term survival and cure fraction estimates for childhood cancer in Europe (EUROCARE-6): results from a population-based study

2022; Elsevier BV; Volume: 23; Issue: 12 Linguagem: Inglês

10.1016/s1470-2045(22)00637-4

1474-5488

Laura Botta, Gemma Gatta, Riccardo Capocaccia, Charles Stiller, Adela Cañete, Luigino Dal Maso, Kaire Innos, Ana Mihor, Friederike Erdmann, Claudia Spix, Brigitte Lacour, Rafael Marcos‐Gragera, Deirdre M. Murray, Silvia Rossi, Monika Hackl, E. Van Eycken, Nancy Van Damme, Z. Valerianova, Mario Šekerija, Vasos Scoutellas, Anna Demetriou, Ladislav Dušek, Denisa Krejčí, Hans H. Storm, Margit Mägi, Kaire Innos, Keiu Paapsi, Nea Malila, Janne Pitkäniemi, Valérie Jooste, Jacqueline Clavel, Claire Poulalhon, Brigitte Lacour, Emmanuel Désandes, Alain Monnereau, Friederike Erdmann, Claudia Spix, Alexander Katalinic, Eleni Petridou, Georgios Markozannes, Miklós Garami, Helgi Birgisson, Deirdre M. Murray, Paul Walsh, Guido Mazzoleni, Fabio Vittadello, Francesco Cuccaro, Rocco Galasso, Giuseppe Sampietro, Stefano Rosso, C. Gasparotto, Giovanni Maifredi, Margherita Ferrante, Antonina Torrisi, Antonella Sutera Sardo, Maria Letizia Gambino, Monica Lanzoni, Paola Ballotari, Erica Giacomazzi, Stefano Ferretti, Adele Caldarella, Gianfranco Manneschi, Gemma Gatta, Milena Sant, Paolo Baili, Franco Berrino, Laura Botta, Annalisa Trama, Roberto Lillini, Alice Bernasconi, S. Bonfarnuzzo, Claudia Vener, Fabio Didonè, Paolo Lasalvia, G. Monego, Lucia Buratti, Diego Serraino, Martina Taborelli, Riccardo Capocaccia, Roberta De Angelis, Elena Demuru, Corrado Di Benedetto, Silvia Rossi, Mariano Santaquilani, Serenella Venanzi, Marco Tallon, Luca Boni, Silvia Iacovacci, Antonio Russo, Federico Gervasi, Gianbattista Spagnoli, Luca Cavalieri d'Oro, Mario Fusco, Maria Francesca Vitale, Mario Usala, Francesco Vitale, Maria Michiara, Giorgio Chiranda, Carlotta Sacerdote, Milena Maule, Giuseppe Cascone, Eugenia Spata, Lucìa Mangone, Fabio Falcini, Rossella Cavallo, Daniela Piras, Ylenia Maria Dinaro, Marine Castaing, Anna Clara Fanetti, Sante Minerba, Giuseppina Candela, T. Scuderi, Roberto Vito Rizzello, Fabrizio Stracci, Giovanna Tagliabue, Massimo Rugge, Angelita Brustolin, Santa Pildava, Giedrė Smailytė, Miriam Azzopardi, Tom Børge Johannesen, Joanna Didkowska, Urszula Wojciechowska, Magdalena Bielska‐Lasota, Ana Pais, Ana Maria Reis Ferreira, Maria José Bento, Ana Miranda, Chakameh Safaei Diba, Vesna Zadnik, Tina Žagar, Carmen Sánchez-Contador Escudero, P. Franch Sureda, Arantza López de Munain, Marta De-La-Cruz, Marìa Dolores Rojas, Araceli Alemán, Ana Vizcaíno, Fernando Almela, Rafael Marcos‐Gragera, Arantza Sanvisens, María‐José Sánchez, María Dolores Chirlaque, Antonia Sánchez-Gil, Marcela Guevara, Eva Ardanáz, Adela Cañete-Nieto, Rafael Peris‐Bonet, Jaume Galceran, Marià Carulla, Claudia E. Kuehni, Shelagh Redmond, Otto Visser, Henrike E. Karim‐Kos, Sarah E. Stevens, Charles Stiller, Anna Gavin, David Morrison, Dyfed Wyn Huws,

Lymphoma Diagnosis and Treatment

Background The EUROCARE-5 study revealed disparities in childhood cancer survival among European countries, giving rise to important initiatives across Europe to reduce the gap. Extending its representativeness through increased coverage of eastern European countries, the EUROCARE-6 study aimed to update survival progress across countries and years of diagnosis and provide new analytical perspectives on estimates of long-term survival and the cured fraction of patients with childhood cancer. Methods In this population-based study, we analysed 135 847 children (aged 0–14 years) diagnosed during 2000–13 and followed up to the end of 2014, recruited from 80 population-based cancer registries in 31 European countries. We calculated age-adjusted 5-year survival differences by country and over time using period analysis, for all cancers combined and for major cancer types. We applied a variant of standard mixture cure models for survival data to estimate the cure fraction of patients by childhood cancer and to estimate projected 15-year survival. Findings 5-year survival for all childhood cancer combined in Europe in 2010–14 was 81% (95% CI 81–82), showing an increase of three percentage points compared with 2004–06. Significant progress over time was observed for almost all cancers. Survival remained stable for osteosarcomas, Ewing sarcoma, Burkitt lymphoma, non-Hodgkin lymphomas, and rhabdomyoscarcomas. For all cancers combined, inequalities still persisted among European countries (with age-adjusted 5-year survival ranging from 71% [95% CI 60–79] to 87% [77–93]). The 15-year survival projection for all patients with childhood cancer diagnosed in 2010–13 was 78%. We estimated the yearly long-term mortality rate due to causes other than the diagnosed cancer to be around 2 per 1000 patients for all childhood cancer combined, but to approach zero for retinoblastoma. The cure fraction for patients with childhood cancer increased over time from 74% (95% CI 73–75) in 1998–2001 to 80% (79–81) in 2010–13. In the latter cohort, the cure fraction rate ranged from 99% (95% CI 74–100) for retinoblastoma to 60% (58–63) for CNS tumours and reached 90% (95% CI 87–93) for lymphoid leukaemia and 70% (67–73) for acute myeloid leukaemia. Interpretation Childhood cancer survival is increasing over time in Europe but there are still some differences among countries. Regular monitoring of childhood cancer survival and estimation of the cure fraction through population-based registry data are crucial for evaluating advances in paediatric cancer care. Funding European Commission.