title: Survival of adolescents with cancer treated at pediatric versus adult oncology treatment centers in France.
abstract: In France, although children aged less than 15 years with cancer are usually referred to pediatric oncology centers, adolescents may be treated at pediatric or adult oncology centers. The objective was to compare survival according to their site of treatment.
  
  
  
  Using population-based registration, 15- to 19-year-old patients diagnosed with cancer in 2006 or 2007 and living in six French regions (accounting for 41% of the French population) were included.
  
  
  
  Of the 594 patients included, 33% of the French adolescents were treated at a pediatric oncology center. Compared with those treated at a pediatric center, adolescents treated at an adult center were older, were more likely to have carcinoma and germ-cell tumor, had a longer time to diagnosis, and were less likely to be enrolled in a clinical trial. In addition, the decisions for their management were less likely to be taken in the context of multidisciplinary team meetings. In multivariate analysis, adolescent patients treated at a pediatric center did not have significantly different overall survival (OS) compared with those treated at an adult center (5-year OS: 84.1% [95% confidence interval: 78.6-90.0] versus 87.7% [95% confidence interval: 84.2-91.3]; P = 0.25).
  
  
  
  The outcomes of French adolescents with cancer have begun to improve, with 81.2% survival in 2006-2007, with no difference between the types of treatment center. However, for this unique group of diseases, survival is not the unique endpoint. In order to ensure good quality of life after cancer, management of those patients requires specific approaches, designed to reduce the late effects of cancer treatment and improve supportive care.
authors.affiliation: French National Registry of Childhood Cancer-French National Registry of Childhood Solid Tumors, University Hospital Centre of Nancy, Vandoeuvre-lès-Nancy, France.|Inserm UMRS-1153, CRESS team 7, University of Paris-Sorbonne, Paris, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Desandes
authors.affiliation: Department of Pediatric and Adolescent Oncology, Gustave Roussy, Villejuif, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Brugieres
authors.affiliation: Oncology Department, Curie Institute, Paris, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Laurence
authors.affiliation: Rhône-Alpes Childhood Cancer Registry, University Hospital Centre of St-Etienne, St-Etienne, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Berger
authors.affiliation: Childhood Cancer Registry of Auvergne/Limousin, Inserm CIC 501, University Hospital Centre of Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Justyna
authors.initials: J
authors.lastname: Kanold
authors.affiliation: Childhood Cancer Registry of Bretagne, ORS Rennes, Rennes, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Tron
authors.affiliation: Inserm UMRS-1153, CRESS team 7, University of Paris-Sorbonne, Paris, France.|French National Registry of Childhood Cancer-French National Registry of Childhood Hematological Malignancies, Villejuif, France.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Clavel
authors.affiliation: French National Registry of Childhood Cancer-French National Registry of Childhood Solid Tumors, University Hospital Centre of Nancy, Vandoeuvre-lès-Nancy, France.|Inserm UMRS-1153, CRESS team 7, University of Paris-Sorbonne, Paris, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Lacour
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy*; D016522:Oncology Service, Hospital / Q000706:statistics & numerical data*; D011788:Quality of Life; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
keywords: adolescents; cancer; care units; population-based study; survival