Evaluation of treatment-related mortality among paediatric cancer deaths: a population based analysis.
Level 3 - non-randomized controlled study
Retrospective population-based registry cohort study
PubMed 28095399 · doi:10.1038/bjc.2016.443
What was done
Researchers identified 964 pediatric cancer patients aged 18 years or younger diagnosed and treated in Ontario, Canada, who died between January 2003 and December 2012, using the Pediatric Oncology Group of Ontario Networked Information System registry. After exclusions, 821 deaths were analyzed using multiple regression to identify predictors and causes of treatment-related mortality (TRM) versus disease progression.
What was found
Of 821 analyzed deaths, TRM accounted for 26.4% (217/821) and progressive cancer accounted for 73.6% (604/821). The median age at diagnosis was 6.6 years (range 0–18.8), and 51.8% had experienced at least one relapse. TRM proportions did not change over time. Using multiple regression, younger age, leukemia diagnosis, and absence of relapse were independently positively associated with TRM. The most common probable causes of TRM were respiratory, infection, and haemorrhage.
Why it matters
Treatment-related toxicity causes more than one-quarter of deaths among children with cancer, highlighting that supportive care improvements remain critical, particularly in younger patients and those with leukemia.
Limits
The study evaluated only deceased patients rather than an inception cohort of all newly diagnosed patients, precluding absolute risk calculations for TRM. Specific numerical effect sizes (odds ratios, confidence intervals) and detailed cause breakdowns by diagnosis were not reported in the abstract.
Cited by
- contradicts About 50% of cancer deaths are caused by treatment-related complications rather than the cancer itself.