FACTORS THAT INFLUENCE THE FURTHER SURVIVAL OF PATIENTS WHO SURVIVE FOR 5 YEARS AFTER THE DIAGNOSIS OF CANCER IN CHILDHOOD OR ADOLESCENCE

To evaluate the further survival, and to identify disease and treatmen t factors which influence the further survival, of five-year survivors of cancer diagnosed during childhood or adolescence, we reviewed the courses of 591 previously untreated patients who were less than 20 yea rs of age at diagnosis and survived for five years after diagnosis. Fi fty-three of 143 patients who experienced disease recurrence during th e first five years after diagnosis died during the period of observati on, compared to 18 of 448 patients who did not experience disease recu rrence during the first five years after diagnosis. The sex-specific s tandardized mortality ratios for the group of patients who never relap sed or relapsed more than five years after diagnosis were not signific antly different from those of the New York State population. Cox propo rtional hazards modelling of the subgroup of patients who relapsed dur ing the first five years after diagnosis demonstrated that disease whi ch was treated surgically, a diagnosis of Hodgkin's disease or acute l ymphoblastic leukemia, and older age at diagnosis were significantly a ssociated with further survival in this group, whereas similar modelli ng of the patients who did not experience disease recurrence during th e first five years after diagnosis failed to identify any variables wh ich were associated with continued survival. The results of this study suggest that childhood and adolescent cancer patients who survive for five years without disease recurrence have a survival rate similar to that of the general population. Continued follow-up of this cohort is required to determine if the present findings can still be demonstrat ed as the majority of the cohort ages beyond 35 years of age. (C) 1994 Wiley-Liss, Inc.