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Late recurrence of childhood cancers appears to occur most often in Ewing’s sarcoma and astrocytoma, according to the results of a study published in the Journal of the National Cancer Institute.

As cancer treatment has improved and evolved, the number of survivors of childhood and adolescent cancers has increased; however, there is limited data regarding late recurrence of these cancers. Researchers performed a retrospective analysis of patients treated for pediatric cancer in order to evaluate patterns of late recurrence.

The review included data collected from 12,795 patients with no history of recurrence within the first five years of diagnosis. The median age at original diagnosis was 8.3 years; 806 patients experienced a recurrence five or more years after diagnosis.

The cumulative incidence of recurrence between five and 20 years was 6.2%. Survivors of astrocytoma had the highest 20-year cumulative incidence (14.4%), followed by survivors of Ewing’s sarcoma (13%). Survivors of kidney cancer had the lowest risk of recurrence after 20 years.

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The researchers found that the greatest risk factors for late recurrence included diagnosis, combination treatment with chemotherapy and radiation, and earlier treatment era. They assert that late recurrence is a risk for some childhood cancers, yet the risk might be abated by being informed and remaining vigilant about follow-up.


Wasilewski-Masker K, Liu Q, Yasui Y, et al. Late recurrence in pediatric cancer: A report from the Childhood Cancer Survivor Study. Journal of the National Cancer Institute. 2009; 101: 1709-1720.

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