Role of surveillance screening in detecting tumor recurrence after treatment of childhood cancers

OBJECTIVE: As the survival rates in children with cancer reach up to 80%, this improvement in survival increases the number of patients under follow-up. After cancer treatment is completed, patients are taken to follow-up surveillance to ensure the early detection of recurrence and the late effects of treatments. The frequency and necessity of surveillance screening tests are controversial. This study aimed to assess the efficacy of surveillance screening in the detection of recurrence. MATERIAL AND METHODS: The files of 533 children who were diagnosed as having cancer at our pediatric oncology clinic between 2004 and 2013 were retrospectively evaluated. We looked at outcomes after recurrence, the timing and pattern of recurrence, the presence of symptoms during recurrence, physical examination findings, tumor marker levels, laboratory findings, and radiologic tests. RESULTS: Of the 63 patients with recurrence, 23 were symptomatic and 40 were asymptomatic at the time of the recurrence. Tumor location and time of the recurrence did not affect the post recurrence survival. The median post-recurrence survival for patients was 13 (range, 1–98) months. The median post-relapse survival was 10 (range, 1–73) months in patients with symptomatic recurrence, and 16 (range, 1–98) months in patients with asymptomatic recurrence. It was determined that patients in whom recurrence was identified with surveillance tests had longer post-relapse survival time. The 5-year survival rate of 23 patients with symptomatic recurrence was 12.2%; this rate was 49.5% in asymptomatic patients (p<0.05). CONCLUSIONS: It should be considered that surveillance testing offers the benefit of prolonging post recurrence survival.