Adherence to long-term follow-up in paediatric oncology - Results of a monocentric analysis

Welsch S., Hense H., Groll A., Fröhlich B., Goletz G., Wältermann M., Jürgens H.

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.