A M J Reedijk1, M van der Heiden-van der Loo2, O Visser3, H E Karim-Kos4, J A Lieverst5, J G de Ridder-Sluiter5, J W W Coebergh4, L C Kremer6, R Pieters7. 1. Princess Máxima Center for Pediatric Oncology, Uppsalalaan 8, Utrecht 3584 CT, The Netherlands; Dutch Childhood Oncology Group, Zinkwerf 5-7, The Hague 2544 EC, The Netherlands. Electronic address: a.m.j.reedijk@prinsesmaximacentrum.nl. 2. Princess Máxima Center for Pediatric Oncology, Uppsalalaan 8, Utrecht 3584 CT, The Netherlands; Dutch Childhood Oncology Group, Zinkwerf 5-7, The Hague 2544 EC, The Netherlands. 3. Comprehensive Cancer Organization the Netherlands, Godebaldkwartier 419, Utrecht 3511 DT, The Netherlands. 4. Department of Public Health, Erasmus MC University Medical Center, PO Box 2040, Rotterdam 3000 CA, The Netherlands. 5. Dutch Childhood Oncology Group, Zinkwerf 5-7, The Hague 2544 EC, The Netherlands. 6. Princess Máxima Center for Pediatric Oncology, Uppsalalaan 8, Utrecht 3584 CT, The Netherlands; Dutch Childhood Oncology Group, Zinkwerf 5-7, The Hague 2544 EC, The Netherlands; Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands. 7. Princess Máxima Center for Pediatric Oncology, Uppsalalaan 8, Utrecht 3584 CT, The Netherlands.
Abstract
BACKGROUND: Due to the complexity of diagnosis and treatment, care for children and young adolescents with cancer preferably occurs in specialised paediatric oncology centres with potentially better cure rates and minimal late effects. This study assessed where children with cancer in the Netherlands were treated since 2004. METHODS: All patients aged under 18 diagnosed with cancer between 2004 and 2013 were selected from the Netherlands Cancer Registry (NCR) and linked with the Dutch Childhood Oncology Group (DCOG) database. Associations between patient and tumour characteristics and site of care were tested statistically with logistic regression analyses. RESULTS: This population-based study of 6021 children diagnosed with cancer showed that 82% of them were treated in a paediatric oncology centre. Ninety-four percent of the patients under 10 years of age, 85% of the patients aged 10-14 and 48% of the patients aged 15-17 were treated in a paediatric oncology centre. All International Classification of Childhood Cancers (ICCC), 3rd edition, ICCC-3 categories, except embryonal tumours, were associated with a higher risk of treatment outside a paediatric oncology centre compared to leukaemia. Multivariable analyses by ICCC-3 category revealed that specific tumour types such as chronic myelogenous leukaemia (CML), embryonal carcinomas, bone tumours other type than osteosarcoma, non-rhabdomyosarcomas, thyroid carcinomas, melanomas and skin carcinomas as well as lower-staged tumours were associated with treatment outside a paediatric oncology centre. CONCLUSION: The site of childhood cancer care in the Netherlands depends on the age of the cancer patient, type of tumour and stage at diagnosis. Collaboration between paediatric oncology centre(s), other academic units is needed to ensure most up-to-date paediatric cancer care for childhood cancer patients at the short and long term.
BACKGROUND: Due to the complexity of diagnosis and treatment, care for children and young adolescents with cancer preferably occurs in specialised paediatric oncology centres with potentially better cure rates and minimal late effects. This study assessed where children with cancer in the Netherlands were treated since 2004. METHODS: All patients aged under 18 diagnosed with cancer between 2004 and 2013 were selected from the Netherlands Cancer Registry (NCR) and linked with the Dutch Childhood Oncology Group (DCOG) database. Associations between patient and tumour characteristics and site of care were tested statistically with logistic regression analyses. RESULTS: This population-based study of 6021 children diagnosed with cancer showed that 82% of them were treated in a paediatric oncology centre. Ninety-four percent of the patients under 10 years of age, 85% of the patients aged 10-14 and 48% of the patients aged 15-17 were treated in a paediatric oncology centre. All International Classification of Childhood Cancers (ICCC), 3rd edition, ICCC-3 categories, except embryonal tumours, were associated with a higher risk of treatment outside a paediatric oncology centre compared to leukaemia. Multivariable analyses by ICCC-3 category revealed that specific tumour types such as chronic myelogenous leukaemia (CML), embryonal carcinomas, bone tumours other type than osteosarcoma, non-rhabdomyosarcomas, thyroid carcinomas, melanomas and skin carcinomas as well as lower-staged tumours were associated with treatment outside a paediatric oncology centre. CONCLUSION: The site of childhood cancer care in the Netherlands depends on the age of the cancerpatient, type of tumour and stage at diagnosis. Collaboration between paediatric oncology centre(s), other academic units is needed to ensure most up-to-date paediatric cancer care for childhood cancerpatients at the short and long term.
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Authors: Johanna M Meulepas; Cécile M Ronckers; Anne M J B Smets; Rutger A J Nievelstein; Patrycja Gradowska; Choonsik Lee; Andreas Jahnen; Marcel van Straten; Marie-Claire Y de Wit; Bernard Zonnenberg; Willemijn M Klein; Johannes H Merks; Otto Visser; Flora E van Leeuwen; Michael Hauptmann Journal: J Natl Cancer Inst Date: 2019-03-01 Impact factor: 13.506