Neurocognitive performance was converted to age-adjusted z-scores (M = 0, SD = 1.0), based on population norms.

The survivors were 48% female, with a median time since diagnosis of 24 years (range, 10–51 years). Median age at cancer diagnosis was 7 years (range, 0–24 years), and median age at follow-up was 32 years (range, 18–66 years). About half of the participants had leukemia, followed by solid tumors, lymphoma, and CNS tumors.


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A total of 232 survivors (12%) had seizures; of this group, 54% had been diagnosed with leukemia: 31% with CNS tumors, 9% with solid tumors, and 6% and lymphoma. Seizure frequency was highest among those who had CNS tumors (30%), followed by those with leukemia (13%), solid tumors (5%), and lymphoma (4%). Overall, “36% of survivors had unresolved seizures,” Dr Sadighi noted, which was the “single most common predictor of poor outcome.”

Adjusted for age, gender, cranial radiation, conformal radiation therapy, and antimetabolites, study results showed that seizures were associated with poorer performance on cognitive flexibility (CNS tumor effect size [ES] = –0.74, P = .02; non-CNS tumor ES = –0.68, P < .001), fluency (non-CNS tumor ES = –0.37, P < .001), and short-term memory (CNS tumor ES = –0.63, P = .001; non-CNS tumor ES = –0.46, P < .001).

Similar effects were observed for attention and processing speed.

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The authors found presence of seizures, severity of past seizures, and resolution of seizures had no impact on HRQOL. However, the presence of seizures was associated with less than full-time employment. The relative risk was 1.09 (95% CI, 1.01 – 1.18) for CNS survivors and 1.1 (95% CI, 1.05 – 1.17) for non-CNS survivors. There was no difference between the CNS and non-CNS survivor groups for the effect of seizure severity on educational attainment, employment, income, or marital status.

Reference

  1. Sadighi Z, Khan R, Zabrowski J, et al. Effect of seizure morbidity on neurocognitive outcome, quality of life, and social attainment in adult survivors of childhood cancer. Poster presented at: 68th Annual Meeting of the American Academy of Neurology; April 15-21, 2016; Vancouver, BC, Canada.