Abstract
Population-based EUROCARE-5 studies demonstrated that childhood cancer survival rates in Lithuania were 10-20% lower than theEuropean mean. We aimed to analyse thechange in theoutcome of treatment of paediatric malignancies in Lithuania over 30 years. Asingle-centre retrospective analysis of children below 18 years of age treated for cancer at Vilnius University Hospital Santaros Klinikos between 1982 and 2011 was carried out. Theminimal requirement of 5-year follow-up after diagnosis was specified for survival estimation. Thevital status was assessed using data from thepopulation-based Lithuanian Cancer Registry. To evaluate changes over time, theentire cohort was split into three groups according to thetime of diagnosis: 1982-1991, 1992-2001, and 2002-2011. A total of 1268 children met the inclusion criteria. Theshortest median follow-up was 8.9 (IQR 6.4-11.5) years for patients treated in thethird decade. The5-year overall survival of theentire cohort increased from 37.3% (95% CI 30.2-44.3) in 1982-1991 to 70.7% (95% CI 66.4-74.1) in 2002-2011 (p<0.0001). Thesame trend was evident when calculated separately for leukaemia (p<0.0001), lymphoma (p<0.0005), and solid tumours (p<0.004). Thepercentage of cure rose from zero in theearly years of theperiod analysed to 80% in 2010 and 2011. Theimprovement in thetreatment outcome was attributable to thereduction of treatment-related mortality from 45.8% in 1982-1991 to 12.4% in 2002-2011 and disease recurrence from 30.4% to 19.6% for thesame periods, respectively. Significant progress in thecure rate of children treated for cancer at our institution was observed over 30 years. Collaborative national and international clinical and research efforts are crucial to ensure further advances in care and cure.
Highlights
The 5-year overall survival of the entire cohort increased from 37.3% in 1982–1991 to 70.7% in 2002–2011 (p < 0.0001)
Series of population-based EUROCARE-5 studies demonstrate that survival rates of childhood cancer in Lithuania are 10–20% lower than the European mean [4,5,6]
Despite increasing absolute patient number over the analysed period, the treatment groups did not differ with regard to the distribution by Leukaemia acute lymphoblastic leukaemia (ALL) acute myeloblastic leukaemia (AML) chronic myeloid leukaemia (CML) JMML MDS*
Summary
Childhood cancer remains a major public health issue in Europe [2]. Series of population-based EUROCARE-5 studies demonstrate that survival rates of childhood cancer in Lithuania are 10–20% lower than the European mean [4,5,6]. Considerable advances in the outcome of treatment in Lithuanian were reported in population-based studies on childhood leukaemia [9, 10] and single-centre analyses on solid tumours [11,12,13]. Population-based EUROCARE-5 studies demonstrated that childhood cancer survival rates in Lithuania were 10–20% lower than the European mean. We aimed to analyse the change in the outcome of treatment of paediatric malignancies in Lithuania over 30 years
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