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

• Published in: Klinische Padiatrie Vol. 227; no. 3; p. 144
• Main Authors: Welsch, S, Hense, H-W, Groll, A, Fröhlich, B, Goletz, G, Wältermann, M, Jürgens, H
• Format: Journal Article
• Language: German
• Published: Germany 01-05-2015
• Subjects: 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; Germany
• ISSN: 1439-3824
• DOI: 10.1055/s-0034-1398629

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