The evaluation of long term follow-up (LTFU) of children with osteosarcoma: The first report from a center in a developing country.

Abstract

e21512 Background: The increased survival rate of childhood cancers resulted in long term side effects (LTSE). The aim was to investigate LTSE in our osteosarcoma survivors and compare the quality of life (QOL criteria with their own siblings as a developing country experience with no National LTFU guideline yet . Methods: At Ankara University Department of Pediatric Oncology 54 osteosarcoma pts have been followed between 2003- 2019 . Rate of heart, kidney disease, hearing difficulty, neurological problems, Life style parameters like; smoking, alcohol consumption, marital status, parenthood, education, the use of health care services and pain status of the 39 survivors were compared with their siblings (n = 77). Amputated and non-amputated groups were compared for QOL. Information obtained retrospectively from the patient charts, and phone calls. Kaplan-Meier, Chi-square, independent sample t-test were used. Results: The age and gender ratios were similar in the groups. The 16-year overall survival rate (OSR) was 72.4%. Patients with the poor risk criteria were in the Euramos MAP + IE regimen with 71.4% OSR ; 94.1%, in the low risk patients in Euramos MAP (p = 0.023) and 50.0% in the previous HDMTX regimens (p = 0.012). The rates of kidney (p = 0.045), heart disease (p < 0.001), neurological problems (p = 0.045), use of health care services (p < 0.001), limitations of physical function (p < 0.001) and pain (p = 0.002) were significantly higher in the survivors than siblings. The physical functions were normal in 76 siblings (98.7%) and in 14 of the survivors (35.9%) (p < 0.001). Being married (p = 0.001), having parenthood (p < 0.001), educated (p = 0.014) and employed (p < 0.001) were significantly higher in the siblings than in the survivors. The rates of hearing problems, smoking, alcohol consumption and psychiatric problems were similar in both groups. Secondary malignancy (1 leukemia, 1 bone tumor) was detected in two survivors while no cancer was found in the control group. The OS was 55.6% and 75.6% respectively in patients with amputation and with no amputation with no significant difference in the QOL (p = 0.424). Conclusions: Heart, neurological and kidney disease, physical dysfunction, and pain rates were significantly higher in survivors of osteosarcoma than their siblings in almost 2 decades. The social status (marriage, parenthood, education) of the survivors was also found to be markedly affected negatively. As we planned, development of risk-based LTFU guidelines are required to increase QOL during LTFU of these patients in our country.