SP-0438: Clinical implications of secondary cancer risks in pediatric and adult patients

Aims and MethodTo assess the part that the 19th century asylums played in the development of the discipline of child psychiatry. Admissions to the Worcester County Asylum between the years 1854 and 1900 were screened to identify children aged 16 and under. An item sheet was used to record details of the admission.ResultsOne-hundred and ninety-five children were admitted. Risk of suicide and dangerousness were routinely recorded, family history rarely. It was not possible to make retrospective diagnoses. The death rate was high and contact with the family was minimal post admission.Clinical ImplicationsChildren were treated exactly like the adult patients, and therefore asylums did not contribute significantly to the development of the discipline of child psychiatry.

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Modelling of organ-specific radiation-induced secondary cancer risks following particle therapy

Radiotherapy and Oncology ◽

10.1016/j.radonc.2016.07.001 ◽

2016 ◽

Vol 120 (2) ◽

pp. 300-306 ◽

Cited By ~ 9

Author(s):

Camilla H. Stokkevåg ◽

Mai Fukahori ◽

Takuma Nomiya ◽

Naruhiro Matsufuji ◽

Grete May Engeseth ◽

...

Keyword(s):

Particle Therapy ◽

Secondary Cancer ◽

Cancer Risks ◽

Organ Specific ◽

Radiation Induced

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Radioactive Iodine Treatment for Children and Young Adults with Thyroid Cancer in South Korea: A Population-Based Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab192 ◽

2021 ◽

Author(s):

Gi Hyeon Seo ◽

Kyoung Ae Kong ◽

Bom Sahn Kim ◽

Young Kang Seo ◽

Byung Seok Moon ◽

...

Keyword(s):

Thyroid Cancer ◽

Young Adult ◽

South Korea ◽

Cancer Incidence ◽

Radioactive Iodine ◽

Population Based ◽

Adult Patients ◽

Secondary Cancer ◽

Observational Period ◽

Iodine Treatment

Abstract Purpose This study investigated radioactive iodine treatment (RAIT) patterns and the secondary cancer incidence among child and young adult patients receiving RAIT after thyroidectomy for thyroid cancer. Methods This population-based cohort study used the Health Insurance Review and Assessment database of South Korea to identify a total of 18,617 child and young adult patients (0–29 years) who underwent thyroidectomy for thyroid cancer between 2008 and 2018. We recorded age at surgery, sex, the interval from surgery to RAIT, the doses of RAI, the number of RAIT sessions, and secondary cancer incidence. Results A total of 9,548 (51.3%) child and young adult patients underwent one or more RAIT sessions. The initial dose of RAIT was 4.35±2.19 GBq. The overall RAIT frequency fell from 60.9 to 38.5% and the frequency of high-dose RAIT (>3.7 GBq) from 64.2 to 36.5% during the observational period. A total of 124 cases of secondary cancer developed during 120,474 person-years of follow-up; 43 (0.5%) in the surgery cohort and 81 (0.8%) in the RAIT cohort. The RAIT cohort was thus at an increased risk of secondary cancer (adjusted hazard ratio 1.52 [95%CI 1.03-2.24], P = 0.035). Conclusion The proportion of child and young adult patients receiving RAIT, and the RAI dose, fell significantly over the observational period. RAIT was associated with secondary cancers. This is of major concern in the context of child and young adult thyroid cancer survivors.

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TP53 germline mutations in the context of families with hereditary breast and ovarian cancer: a clinical challenge

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-020-05883-x ◽

2020 ◽

Author(s):

Sabine Grill ◽

Juliane Ramser ◽

Heide Hellebrand ◽

Nicole Pfarr ◽

Melanie Boxberg ◽

...

Keyword(s):

Ovarian Cancer ◽

P53 Protein ◽

Surveillance Program ◽

Clinical Implications ◽

Cancer Risks ◽

Breast And Ovarian Cancer ◽

Li Fraumeni Syndrome ◽

Pathogenic Variants ◽

Low Incidence ◽

Clinical Subgroup

Abstract Purpose TP53germline (g) mutations, associated with the Li-Fraumeni syndrome (LFS), have rarely been reported in the context of hereditary breast and ovarian cancer (HBOC). The prevalence and cancer risks in this target group are unknown and counseling remains challenging. Notably an extensive high-risk surveillance program is implemented, which evokes substantial psychological discomfort. Emphasizing the lack of consensus about clinical implications, we aim to further characterize TP53g mutations in HBOC families. Methods Next-generation sequencing was conducted on 1876 breast cancer (BC) patients who fulfilled the inclusion criteria for HBOC. Results (Likely) pathogenic variants in TP53 gene were present in 0.6% of the BC cohort with higher occurrence in early onset BC < 36 years. (1.1%) and bilateral vs. unilateral BC (1.1% vs. 0.3%). Two out of eleven patients with a (likely) pathogenic TP53g variant (c.542G > A; c.375G > A) did not comply with classic LFS/Chompret criteria. Albeit located in the DNA-binding domain of the p53-protein and therefore revealing no difference to LFS-related variants, they only displayed a medium transactivity reduction constituting a retainment of wildtype-like anti-proliferative functionality. Conclusion Among our cohort of HBOC families, we were able to describe a clinical subgroup, which is distinct from the classic LFS-families. Strikingly, two families did not adhere to the LFS criteria, and functional analysis revealed a reduced impact on TP53 activity, which may suit to the attenuated phenotype. This is an approach that could be useful in developing individualized screening efforts for TP53g mutation carrier in HBOC families. Due to the low incidence, national/international cooperation is necessary to further explore clinical implications. This might allow providing directions for clinical recommendations in the future.

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