[Adherence to Long-term Follow-up in Paediatric Oncology--Results of a Monocentric Analysis]

Klin Padiatr. 2015 May;227(3):144-50. doi: 10.1055/s-0034-1398629. Epub 2015 Mar 26.
[Article in German]

Abstract

Background: Cured paediatric-oncology patients frequently present with health problems even years after treatment. Hence long-term follow-up (LTFU) is essential. This analysis tries to identify factors that influence regular LTFU attendance.

Study population: Between 1991 and 2010, 2 153 children and adolescents were treated at Muenster University Department of Paediatric Hematology and Oncology (UKM). 1 708 patients with permanent residence in Germany and completed therapy have been included into this analysis.

Methods: Patients were reviewed for the duration and regularity of LTFU at UKM. Prospective analyses with postponed starting-points have been conducted as well as descriptive analyses to validate correlations. Prospective data were evaluated by Kaplan-Meier-Analyses, the analysis of multivariate correlations by Cox Proportional Hazard Model.

Results: 2 years after the end of therapy 83% of the patients were still in LTFU. After 5 and 10 years this percentage decreased to 67 and 42%. Patients diagnosed after the year 2000 and younger patients attended LTFU for a longer period (p<0,005). There were no significant gender differences. Statutory insured patients stayed longer in LTFU than private health insured (p<0,005). The multivariate examination showed only small differences between systemic diseases and solid tumours. The residential distance had no significant influence.

Conclusions: Younger, more recently treated and statutory insured patients showed a significantly longer LTFU.

Publication types

  • English Abstract

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Cause of Death
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Germany
  • Health Services Accessibility
  • Hospitals, University
  • Humans
  • Infant
  • Infant, Newborn
  • Kaplan-Meier Estimate
  • Long-Term Care*
  • Male
  • Multivariate Analysis
  • National Health Programs
  • Neoplasm Recurrence, Local / complications
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / therapy
  • Neoplasms / complications*
  • Neoplasms / mortality
  • Neoplasms / therapy*
  • Patient Compliance*
  • Patient Dropouts / statistics & numerical data
  • Prospective Studies
  • Retrospective Studies
  • Young Adult