title: Long-term complications in survivors of advanced stage neuroblastoma.
abstract: BACKGROUND
  Few studies have assessed late effects in neuroblastoma (NB) survivors, particularly those with advanced stage disease.
  
  
  METHODS
  Retrospective analysis of a cohort of advanced stage NB survivors followed in a late effect clinic at a single institution. Screening tests to detect late effects were tailored depending on the individual's treatment exposures.
  
  
  RESULTS
  The study included 63 survivors (31 males). The median age at diagnosis was 3.0 years. The median follow-up from diagnosis was 7.06 years. All patients had surgery and received chemotherapy, 89% received radiation therapy (RT), 62% immunotherapy, and 56% autologous stem cell transplant. Late complications were detected in 95% of survivors and included: hearing loss (62%), primary hypothyroidism (24%), ovarian failure (41% of females), musculoskeletal (19%), and pulmonary (19%) abnormalities. The majority of complications were moderate, with only 4% being life-threatening. Survivors who received cisplatin were at greater risk to develop hearing loss compared to those not so treated (OR 9.74; 95% CI: 0.9-101.6). A total dose of cyclophosphamide greater than 7.4 g was associated with ovarian failure (P = 0.02).
  
  
  CONCLUSIONS
  Late complications occur frequently in survivors of advanced stage NB. The majority of these problems are of mild-moderate severity. Long-term follow-up (LFTU) and screening of this population is essential.
authors.affiliation: Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Laverdière
authors.forename: Nai-Kong V
authors.initials: NK
authors.lastname: Cheung
authors.forename: Brian H
authors.initials: BH
authors.lastname: Kushner
authors.forename: Kim
authors.initials: K
authors.lastname: Kramer
authors.forename: Shakeel
authors.initials: S
authors.lastname: Modak
authors.forename: Michael P
authors.initials: MP
authors.lastname: LaQuaglia
authors.forename: Suzanne
authors.initials: S
authors.lastname: Wolden
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.forename: James G
authors.initials: JG
authors.lastname: Gurney
authors.forename: Charles A
authors.initials: CA
authors.lastname: Sklar
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000009:adverse effects; D004700:Endocrine System Diseases / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000209:etiology; D009447:Neuroblastoma / Q000150:complications* / Q000628:therapy*; D009519:New York City / Q000453:epidemiology; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D017741:Survivors
chemical_list: D000970:Antineoplastic Agents