Long-term complications of neuroblastoma: A report from the Childhood Cancer Survivor Study
Bibliographic record
Abstract
9544 Background: Neuroblastoma (NB) survivors can develop many complications from their treatment. We evaluated long-term morbidity and mortality in a large cohort of NB survivors. Procedures: Late effects data from 5-year NB survivors diagnosed between 1970–1986 enrolled in the Childhood Cancer Survivor Study (CCSS) were collected from self-administered questionnaires. 832 survivors and 3,899 siblings were included. Treatment data were abstracted from the medical records of all survivors. Late mortality, second malignant neoplasm (SMN), and chronic health conditions were analyzed in relation to treatment factors. Results: 42 survivors (6%) died more than 5 years after their diagnosis (standardized mortality ratio [SMR]:4.8; 95% CI 3.5–6.5). Causes of death included: disease recurrence (n=23), SMN (n=6) (SMR: 8.5; 95% CI 3.1–18.4), cardiac (n=1) (SMR 2.9; 95% CI 0.04–16.0), pulmonary (n=1) (SMR 4.8; 95% CI 0.1–26.5), external causes (n=4), other and unknown (n=11). 33 developed a SMN (standardized incidence ratio [SIR] 8.6; 95% CI 5.9–12.1): thyroid (n=7), renal (n=6), soft tissue sarcomas (n=3), acute myeloid leukemia (n=2), breast cancer (n=2) and other (n=13). Exposure to radiation therapy (RT) (p=0.003) and to VP-16 (p=0.04) were significant risk factors for SMN. 38% of the survivors reported at least one chronic health condition. Compared to siblings, they were more likely to report any chronic condition (risk ratio [RR] 14.7; 95% CI, 12.4–17.6). The most common prevalent conditions included: musculoskeletal (RR 49.8; 95% CI, 27.9–88.8), endocrine (RR 36.2; 95%CI 24.1–54.5), sensory (RR 21.5; 95%CI, 14.6–31.7) and neurological (RR 13.1; 95% CI 10.8–16). A multivariable Poisson regression analysis revealed the following associations: laminectomy (RR 8.6; 95% CI 3.5- 21) and chest RT (RR 2.8; 95% CI 1.3–6.5) as risk factors for scoliosis; age < 1 year at diagnosis (RR 1.9; 95% CI 1.4–2.6) and laminectomy (RR 3.5; 95% CI 2.4–5.3) for neurological complications; for hearing loss, increasing cumulative dose of cisplatin (for ≥ 600 mg/m2 RR 52.8; 95% CI 10.2–272.5); and RT to the neck (RR 6.6; 95% CI 2.4–18) for hypothyroidism. Conclusions: NB survivors are at risk of developing chronic conditions. Long-term surveillance is required for early detection of these complications. No significant financial relationships to disclose.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".