Late mortality after childhood XXXX ( @entity981 ).

@entity1 @entity981 @entity66 @entity548 @entity8253 @entity786 @entity281 @entity204
UNASSIGNED: 8508 Background: Long-term outcomes of @entity1 with @entity981 treated on cooperative group trials need to be defined. METHODS: We assessed late mortality [death occurring 5+ years (yrs) after diagnosis (dx)] in a retrospective cohort of 8,444 @entity1 (pts), with @entity981 , treated on @entity1 's Oncology Group (COG) therapeutic protocols between 1979 and 1990. Vital status was determined using medical records, National Death Index, and Social Security Death Index. Age- and sex-standardized mortality ratios (SMR) were calculated using US population mortality data. RESULTS: A total of 6,424 pts (56% males, 80% Caucasians) survived 5+ yrs. Median age at dx was 4.6 yrs, and 15.6 yrs at follow-up. 549 @entity204 occurred 5+ yrs from dx with @entity66 , @entity281 and @entity548 accounting for 65%. Multivariate analysis revealed risk of relapse-related mortality to be lower in females (Relative Risk (RR)=0.8, p=0.03), dx at age 1 to 10 yrs (RR=0.5, p=0.02) and dx after 1985 (RR=0.6, p=0.01). Non-relapse-related mortality was lower among females (RR=0.7, p=0.02). The cohort was at a 7.5-fold increased risk of late death when compared with the general population (Table). Overall survival at 20 years was 91%, 99%, and 99.4% for 5+, 10+ and 15+ yr survivors, respectively. Therapeutic summaries were available for a subcohort of 2,929 5-yr survivors treated between 1983-1989. The overall survival was 91.5% at 15 yrs, and the subcohort was at a 7.8-fold risk of late death. @entity8253 (>200 mg/m(2): RR=0.6, p=0.07) and @entity786 (>2000 mg/m(2): RR=0.7, p=0.06) offered protection against 5+ yr relapse-related mortality. @entity8253 did not increase the risk of @entity204 due to cardiac causes. CONCLUSIONS: At 15 yrs from dx, risk of late death is no longer elevated among @entity981 survivors. [Figure: see text] No significant financial relationships to disclose.
