Back to Search
Start Over
Neurocognitive outcomes in long-term survivors of Wilms tumor: a report from the St. Jude Lifetime Cohort.
- Source :
-
Journal of cancer survivorship : research and practice [J Cancer Surviv] 2019 Aug; Vol. 13 (4), pp. 570-579. Date of Electronic Publication: 2019 Jun 26. - Publication Year :
- 2019
-
Abstract
- Purpose: To examine prevalence and predictors of neurocognitive outcomes, social attainment, emotional distress, and health-related quality of life (HRQOL) in long-term survivors of pediatric Wilms tumor (WT).<br />Methods: One hundred fifty-eight WT survivors (59% female; mean [SD] age 33 [9.1] years; time since diagnosis 29 [9.1] years) and 354 community controls (55.6% female; 35 [10.2] years) completed comprehensive neuropsychological testing and physical examination, including echocardiography/electrocardiography, pulmonary function tests, and endocrine evaluation. Self-report of emotional distress, HRQOL, and social attainment were collected. Impairment was defined in relation to both controls and normative data. Generalized linear models were developed to examine impact of treatment and chronic health conditions on outcomes.<br />Results: WT survivors performed poorer than norms and controls in 6 of 16 cognitive variables and 1 of 8 HRQOL variables, with scores ranging from - 0.64 (mathematics) to - 0.21 (verbal fluency) standard deviations below expectations. Compared to controls, WT survivors were less likely to graduate college (odds ratio 2.23, 95% confidence interval 1.46-3.41) and had more moderate to severe neurologic conditions (18.4% vs 8.2%, p < 0.001), which were associated with poor memory (β = - 0.90, p < 0.001), attention (β = - 1.02, p < 0.001), and HRQOL general health (β = - 0.80, p = 0.0015). Treatment variables and cardiopulmonary morbidity (higher in survivors) were not associated with outcomes.<br />Conclusions: Survivors of WT demonstrate impairment in neurocognitive function and have lower social attainment during adulthood, with poorer neurocognitive function associated with neurologic morbidity.<br />Implications for Cancer Survivors: Survivors of WT should be offered neurocognitive evaluations and rehabilitation. Neurologic conditions should be routinely assessed, and appropriate support offered to reduce risk for functional limitations.
- Subjects :
- Adolescent
Adult
Attention physiology
Cancer Survivors statistics & numerical data
Child
Cognition physiology
Cohort Studies
Emotions physiology
Female
Humans
Kidney Neoplasms diagnosis
Kidney Neoplasms rehabilitation
Male
Mental Health statistics & numerical data
Neurocognitive Disorders etiology
Neuropsychological Tests
Prevalence
Prognosis
Quality of Life
Social Class
Stress, Psychological epidemiology
Stress, Psychological etiology
United States epidemiology
Wilms Tumor diagnosis
Wilms Tumor rehabilitation
Young Adult
Cancer Survivors psychology
Kidney Neoplasms epidemiology
Kidney Neoplasms psychology
Neurocognitive Disorders epidemiology
Wilms Tumor epidemiology
Wilms Tumor psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1932-2267
- Volume :
- 13
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of cancer survivorship : research and practice
- Publication Type :
- Academic Journal
- Accession number :
- 31243647
- Full Text :
- https://doi.org/10.1007/s11764-019-00776-8