Survivors of childhood cancer have an increased long-term risk of intestinal obstruction requiring surgery (IOS), according to a study published in the Journal of Clinical Oncology.
Arin L. Madenci, M.D., M.P.H., from Boston Children’s Hospital and Harvard Medical School, and colleagues assessed IOS occurring five or more years after cancer diagnosis.
Data were included for 12,316 five-year survivors in the Childhood Cancer Survivor Study (2,002 with and 10,314 without abdominopelvic tumors) and 4,023 sibling participants.
The researchers found that 165 survivors (median age at IOS, 19 years; median time from diagnosis, 13 years) and 14 siblings reported late IOS.
At 35 years, the cumulative incidence of late IOS was 5.8, 1.0, and 0.3 percent among survivors with abdominopelvic tumors, survivors without abdominopelvic tumors, and siblings, respectively.
After adjustment for confounding variables, the rate of late IOS was increased with abdominopelvic tumor (adjusted rate ratio [aRR], 3.6; P < 0.001) and abdominal/pelvic radiotherapy within five years of cancer diagnosis (aRR, 2.4; P < 0.001).
After adjustment for the same variables, developing late IOS correlated with increased subsequent mortality among survivors (aRR, 1.8: P = 0.016).
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“The long-term risk of IOS and its association with subsequent mortality underscore the need to promote awareness of this complication among patients and providers,” the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.