Skip to main content
SpringerLink
Log in

Time trends and prognostic factors for survival from childhood cancer: a report from the Childhood Cancer Registry of Piedmont (Italy)

  • Original Paper
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Survival after childhood cancer has been improving since the late 1970s in most developed countries. The Childhood Cancer Registry of Piedmont has been recording malignant tumors in children (0–14 years) throughout Piedmont since 1967. The present paper is based on the records of the 2,970 children diagnosed during the period 1970–2001; survival rates are estimated up to June 30, 2004. Based on records from the Registrar Offices of the relevant towns of residence, 1,698 children were reported to be alive, 1,252 deceased, and 20 were of unknown vital status. Over the period 1970–2001, 5-year survival rates for all tumor types combined showed a statistically significant increasing trend (p<0.0001). For acute lymphocytic leukemia, the survival rate increased steadily from 24.7% (95% CI 15.0–34.3) in 1970–1974 to 87.8% (82.1–93.6) in 1995–1999. Five-year survival rates for central nervous system tumors increased from 32.8% (21.0–44.6) in 1970–1974 to 80.3% (72.6–88.0) in 1990–1994 and decreased thereafter. Age of less than 1 year at time of diagnosis was a favorable prognostic factor for neuroblastoma and ganglioneuroblastoma. The extent of disease at diagnosis was related to prognosis for neuroblastoma and ganglioneuroblastoma and other selected solid tumors. A white blood cell count greater than 50,000×106 cells/l was associated with decreased survival in children with acute lymphocytic leukemia and acute non-lymphocytic leukemia. We have found positive trends in survival for all tumor types in Piedmont, similar to those reported by other population-based cancer registries. Age, extent of disease, and white blood cell count at diagnosis are prognostic factors for selected cancer sites.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

ALL:

Acute lymphocytic leukemia

ANLL:

Acute non-lymphocytic leukemia

CCRP:

Childhood Cancer Registry of Piedmont

CI:

Confidence interval

CNS:

Central nervous system

FAB:

French-American-British

HR:

Hazard ratio

ICCC:

International classification of childhood cancer

ICD-O:

International classification of diesease for oncology

LFU:

Lost to follow-up

MV:

Microscopic verification

SNS:

Sympathetic nervous system

STS:

Soft tissue sarcomas

WBC:

White blood cell

References

  1. Ajiki W, Tsukuma H, Oshima A (2004) Survival rates of childhood cancer patients in Osaka, Japan. Jpn J Clin Oncol 34:50–54

    Article  PubMed  Google Scholar 

  2. Brodeur GM, Maris JM (2002) Neuroblastoma. In: Pizzo PA, Poplack DG Principles and practice of pediatric oncology, 4th Lippincott, Williams and Wilkins, Philadelphia, pp 895–937

    Google Scholar 

  3. Castleberry RP (1997) Neuroblastoma. Eur J Cancer 33:1430–1437

    Article  PubMed  CAS  Google Scholar 

  4. Coebergh JW, Pastore G, Gatta G, Corazziari I, Kamps W, The Eurocare Working Group (2001) Variation in survival of European children with acute lymphoblastic leukaemia, diagnosed in 1978–92: the EUROCARE study. Eur J Cancer 37:687–694

    Article  PubMed  CAS  Google Scholar 

  5. Cox DR (1972) Regression models and life tables. J R Soc Stat 34:187–220

    Google Scholar 

  6. Douglas NM, Dockerty JD (2005) Population-based survival of children in New Zealand diagnosed with cancer during 1990–1993. Eur J Cancer 41:1604–1609

    Article  PubMed  CAS  Google Scholar 

  7. Feltbower RG, Picton S, Bridges LR, Crooks DA, Glaser AW, McKinney PA (2004) Epidemiology of central nervous system tumors in children and young adults (0–29 years), Yorkshire, United Kingdom. Pediatr Hematol Oncol 21:647–660

    Article  PubMed  CAS  Google Scholar 

  8. Fisher LD, Van Belle G (1993) Biostatistics, a methodology for the health sciences, 10th edn. John Wiley and Sons, New York, pp 801–803

    Google Scholar 

  9. Gatta G, Capocaccia R, Coleman M, Ries LA, Berrino F (2002) Childhood cancer survival in Europe and the United States. Cancer 95:1767–1772

    Article  PubMed  Google Scholar 

  10. Gatta G, Corazziari I, Magnani C, Peris-Bonnet R, Roazzi P, Stiller C, The EUROCARE Working Group (2003) Childhood cancer survival in Europe. Ann Oncol 14 Suppl 5:v119–v127

    Article  PubMed  Google Scholar 

  11. Gatta G, Luksch R, Cleman MP, Corazziari I, The Eurocare Working Group (2001) Survival from acute non-lymphocytic leukaemia (ANLL) and chronic myeloid leukaemia (CML) in European children since 1978: a population based study. Eur J Cancer 37:695–702

    Article  PubMed  CAS  Google Scholar 

  12. Greaves M (2002) Childhood leukaemia review. Brit Med J 324:283–287

    Article  PubMed  Google Scholar 

  13. Green DM (1997) Wilms’ tumour. Eur J Cancer 33:409–418

    Article  PubMed  CAS  Google Scholar 

  14. Kaatsch P, Spix C (2004) German Childhood Cancer Registry. Annual Report 2004 http://info.imsd.uni–mainz.de/K_Krebsregister

  15. Kaplan EL, Meier P (1958) Non parametric estimation from incomplete observations. J Am Stat Assoc 53:457–481

    Article  Google Scholar 

  16. Kramárová E, Stiller CA (1996) The international classification of childhood cancer. Int J Cancer 68:759–765

    Article  PubMed  Google Scholar 

  17. London WB, Boni L, Simon T, Berthold F, Twist C, Lou Schmidt M, Castleberry RP, Matthay KK, Cohn SL, De Bernardi B (2005) The role of age in neuroblastoma risk stratification: the German, Italian, and children’s oncology group perspectives. Cancer Lett 228:257–266

    Article  PubMed  CAS  Google Scholar 

  18. Magnani C, Aareleid T, Viscomi S, Pastore G, Berrino F, The Eurocare Working Group (2001) Variation in survival of children with central nervous system (CNS) malignances diagnosed in Europe between 1978 and 1992: the EUROCARE study. Eur J Cancer 37:711–721

    Article  PubMed  CAS  Google Scholar 

  19. Magnani C, Pannelli F, Mosciatti P, Viscomi S, Rosso S, Spitale AB, Pastore G (2001) Analisi della sopravvivenza per tumore infantile: dati dai registri tumori italiani. Epidemiol Prev 25:347–353

    PubMed  CAS  Google Scholar 

  20. Pannelli F, Mosciatti P, Felici L, Magnani C, Pascucci C, Pastore G (2001) Survival trends of childhood cancer during the period 1978–1994 in Italy: a first report from the Italian cancer registries. Epidemiol Prev 25:354–375

    PubMed  CAS  Google Scholar 

  21. Pastore G, Magnani C, Verdecchia A, Pession A, Viscomi S, Coebergh JW, The EUROCARE Working Group (2001) Survival of childhood lymphomas in Europe, 1978–1992: a report from the EUROCARE study. Eur J Cancer 37:703–710

    Article  PubMed  CAS  Google Scholar 

  22. Pastore G, Mosso ML, Carnevale F, di Montezemolo LC, Forni M, Madon E, Ricardi U, Terracini B, Magnani C (2001) Survival trends of childhood cancer diagnosed during 1970–1994 in Piedmont, Italy: a report from the Childhood Cancer Registry. Med Pediatr Oncol 36:481–488

    Article  PubMed  CAS  Google Scholar 

  23. Percy C, Van Holten V, and Muir C (eds) (1990) International classification of diseases for oncology, 2nd edn. WHO, Geneva

  24. Peto R, Pike MC, Armitage P, Breslow NE, Cox DR, Howard SV, Mantel N, McPherson K, Peto J, Smith PG (1977) Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. Br J Cancer 35:1–39

    PubMed  CAS  Google Scholar 

  25. Pizzo PA, Poplack GG (2002) Principles and practice of pediatric oncology, 4th edn. Lippincot, Williams and Wilkins, Philadelphia, pp 1–1687

    Google Scholar 

  26. Powell JE, Esteve J, Mann JR, Parker L, Frappaz D, Michaelis J, Kerbl R, Mutz ID, Stiller CA (1998) Neuroblastoma in Europe: differences in the pattern of disease in the UK. SENSE. Study group for the evaluation of Neuroblastoma Screening in Europe. Lancet 352:682–687

    Article  PubMed  CAS  Google Scholar 

  27. Reedijk AM, Janssen-Heijnen ML, Louwman MW, Snepvangers Y, Hofhuis WJ, Coebergh JW (2005) Increasing incidence and improved survival of cancer in children and young adults in Southern Netherlands, 1973–1999. Eur J Cancer 41:760–769

    Article  PubMed  Google Scholar 

  28. Ries LAG, Eisner MP, Kosary CL, Hankey BF, Miller BA, Clegg L, Mariotto A, Feuer EJ, Edwards BK (eds) (2005) SEER cancer statistics review, 1975–2002. National Cancer Institute, Bethesda http://www.seer.cancer.gov/csr/1975_2002

  29. Sankila R, Coebergh JW (2000) Cancer registries contribute to quality improvements in clinical care for all European cancer patients. Eur J Cancer 40:635–637

    Article  Google Scholar 

  30. Sauvat F, Sarnacki S, Brisse H, Medioni J, Rubie H, Aigrain Y, Gauthier F, Audry G, Helardot P, Landais P, Michon J, Hartmann O, Nihoul-Fekete C (2002) Outcome of suprarenal localised masses diagnosed during perinatal period: a retrospective multicenter study. Cancer 94:2474–2480

    Article  PubMed  Google Scholar 

  31. Schilling FH, Spix C, Berthold F, Erttmann R, Fehse N, Hero B, Klein G, Sander J, Schwarz K, Treuner J, Zorn U, Michaelis J (2002) Neuroblastoma screening at one year of age. N Engl J Med 346:1047–1053

    Article  PubMed  Google Scholar 

  32. Spix C, Aareleid T, Stiller C, Magnani C, Kaatsch P, Michaelis J, The Eurocare Working Group (2001) Survival of children with neuroblastoma: time trends and regional differences in Europe, 1978–1992. Eur J Cancer 37:722–729

    Article  PubMed  CAS  Google Scholar 

  33. Šteliarová-Foucher E, Stiller C, Kaatsch P, Berrino F, Coebergh JW, Lacour B, Parkin M (2004) Geographical patterns and time trends of cancer incidence and survival among children and adolescents in Europe since 1970s: the ACCIS project. Lancet 364:2097–2105

    Article  PubMed  Google Scholar 

  34. Stiller CA, Eatock EM (1994) Survival from acute non-lmphocytic leukaemia, 1971–88: a population based study. Arch Dis Child 70:219–223

    PubMed  CAS  Google Scholar 

  35. Stiller CA, Eatock EM (1999) Patterns of care and survival for children with acute lymphoblastic leukaemia diagnosed between 1980 and 1994. Arch Dis Child 81:202–208

    Article  PubMed  CAS  Google Scholar 

  36. Strother DR, Poplack IF, Fisher PG, Hunter JV, Woo SY, Pomeroy SL, Rorke LB (2002) Tumors of the central nervous system. In: Pizzo PA, Poplack DG (eds) Principles and practice of pediatric oncology, 4th Lippincott Williams and Wilkins, Philadelphia, pp. 751–824

    Google Scholar 

  37. Terracini B, Coebergh J, Gatta G, Magnani C, Stiller C, Verdecchia A, Zappone A (2001) Childhood cancer survival in Europe: an overview. Eur J Cancer 37:810–816

    Article  PubMed  CAS  Google Scholar 

  38. Tsubono Y, Hisamichi S (2004) A halt to neuroblastoma screening in Japan. N Engl J Med 350:2010–2011

    Article  PubMed  CAS  Google Scholar 

  39. Viscomi S, Pastore G, Mosso ML, Terracini B, Madon E, Magnani C, Merletti F (2003) Population-based survival after childhood cancer diagnosed during 1970–98: a report from the childhood cancer registry of piedmont, Italy. Haematologica 88:974–982

    PubMed  Google Scholar 

  40. Womer RB (1997) Soft tissue sarcomas. Eur J Cancer 33:2230–2236

    Article  PubMed  CAS  Google Scholar 

  41. Woods WG, Gao RN, Shuster JJ, Robison LL, Bernstein M, Weitzman S, Bunin G, Levy I, Brossard J, Dougherty G, Tuchman M, Lemieux B (2002) Screening of infants and mortality due to neuroblastoma. N Engl J Med 346:1041–1046

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The CCRP is supported by the Piedmont Region. This project was partly supported by the “Oncology Special Project”, Compagnia di San Paolo FIRMS, by the Italian Association for Research on Cancer (AIRC), by the special program “Ricerca Sanitaria Finalizzata” of the Piedmont Region and by “University of Eastern Piedmont, local research funds 2003”. We thank Prof. Benedetto Terracini and Prof. Neil Pearce for their insight and for reading the manuscript. We thank Prof. Giuseppe Masera, Prof. Modesto Carli, Prof. Enrico Madon, Prof. Andrea Pession, Dr. Bruno De Bernardi and Dr. Franca Fossati Bellani, chairmen of AIEOP protocols, and Dr Roberto Rondelli for supplying clinical data. A grateful thanks to Mrs. Marinella Nonnato for the careful management of the CCRP data and for the follow-up.

Author information

Authors and Affiliations

  1. Childhood Cancer Registry of Piedmont, Cancer Epidemiology Unit-CPO Piemonte, CeRMS, S. Giovanni Hospital and University of Torino, Torino, Italy

    Elisa Dama, Guido Pastore, Maria Luisa Mosso, Milena Maria Maule, Luisa Zuccolo, Corrado Magnani & Franco Merletti

  2. Division of Pediatrics, Department of Medical Sciences, University of Eastern Piedmont, Novara, Italy

    Guido Pastore

  3. Unit of Medical Statistics and Epidemiology, Department of Medical Sciences, University of Eastern Piedmont, Novara, Italy

    Corrado Magnani

  4. Childhood Cancer Registry of Piedmont, V. Santena 7, 10126, Torino, Italy

    Corrado Magnani

Authors
  1. Elisa Dama
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guido Pastore
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maria Luisa Mosso
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Milena Maria Maule
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luisa Zuccolo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Corrado Magnani
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Franco Merletti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Corrado Magnani.

Appendix

Appendix

Some categories were grouped together: non-Hodgkin lymphoma (ICCC category 02B) with Burkitt lymphoma (02C) and unspecified lymphomas (02E); other gliomas (03D) with other specified intracranial and intraspinal neoplasms (03E) and unspecified intracranial and intraspinal neoplasms (03F); neuroblastoma and ganglioneuroblastoma (04A) with other sympathetic nervous system tumors (04B); fibrosarcoma, neurofibrosarcoma and other fibromatous neoplasms (09B) with other specified soft tissue sarcomas (09D) and unspecified soft tissue sarcomas (09E).

The other categories not mentioned in the paper were all included in the 'other tumor types' group.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dama, E., Pastore, G., Mosso, M.L. et al. Time trends and prognostic factors for survival from childhood cancer: a report from the Childhood Cancer Registry of Piedmont (Italy). Eur J Pediatr 165, 240–249 (2006). https://doi.org/10.1007/s00431-005-0034-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-005-0034-7

Keywords

Search

Navigation