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      • Childhood Cancer Incidence and Survival 1985-2009, Khon Kaen, Thailand

        Wiangnon, Surapon,Jetsrisuparb, Arunee,Komvilaisak, Patcharee,Suwanrungruang, Krittika Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.18

        Background: The Khon Kaen Cancer Registry (KKCR) was established in 1984. Previous population-based incidences and survivals of childhood cancer in Thailand were determined using a short cancer registration period. Materials and Methods: Data were retrieved of all children residing in Khon Kaen, between 0-15 years, diagnosed as having cancer and registered in the KKCR (1985-2009). The follow-up censored date was December 31, 2012. The childhood cancers were classified into 12 diagnostic groups, according to the International Classification of Childhood Cancer. The incidence was calculated by the standard method. Survival of childhood cancer was investigated using the KKCR population-based registration data and overall survival calculated using the Kaplan Meier method. Results: In the study period, 912 newly diagnosed cases of childhood cancer were registered. The respective mean and median age was 6.4 (SD=4.6) and 6 (0-14) years. The age-peak for incidence was 0-4 years. The age-standardized rate (ASR) was 83 per million. Leukemia was the most common cancer (N=360, ASR 33.8) followed by neoplasms of the central nervous system (CNS, N=150, ASR 12.8) and lymphoma (N=79, ASR 7.0). The follow-up duration totaled 101,250 months. The death rate was 1.11 per 100 person-months (95%CI: 1.02 -1.20). The 5-year overall survival was 52% (95%CI: 53-56.9) for all cancers. The respective 5-year overall survival for (1) acute lymphoblastic leukemia (ALL), (2) acute non-lymphoblastic leukemia (ANLL), (3) lymphoma, (4) germ cell tumors, (5) renal tumors, (6) retinoblastoma, (7) soft tissue tumors, (8) CNS tumors, (9) bone tumors, (10) liver tumors, and (11) neuroblastoma was (1) 51%, (2) 37%, (3) 63%, (4) 74%, (5) 67%, (6) 55%, (7) 46%, (8) 44%, (9) 36%, (10) 34%, and (11) 25%. Conclusions: The incidence of childhood cancer is lower than those of western countries. Respective overall survival for ALL, lymphoma, renal tumors, liver tumors, retinoblastoma, soft tissue tumors is lower than that reported in developed countries while survival for CNS tumors, neuroblastoma and germ cell tumors is comparable.

      • Incidence and Survival Rates among Pediatric Osteogenic Sarcoma Cases in Khon Kaen, Thailand, 1985-2010

        Wiromrat, Pattara,Jetsrisuparb, Arunee,Komvilaisak, Patcharee,Sirichativapee, Winai,Kamsa-Ard, Supot,Wiangnon, Surapon Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.9

        Background: Osteosarcoma is the most common bone cancer in children, responsible for a high rate of amputation and death. This is the first long-term, population-based, epidemiologic and survival study in Thailand. Objective: To study the incidence and survival rates of pediatric osteosarcoma in Khon Kaen. Method: Childhood osteosarcoma cases (0-19 years) diagnosed between 1985-2010 were reviewed. The data were retrieved from the population-based data set of the Khon Kaen Cancer Registry and medical records from Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. All cases were censored until the end of April 2012. The age-standardized incidence rate (ASR) was calculated using the standard method. Survival experience was analyzed using the standard survival function (STATA 9.0) and presented with a Kaplan-Meier curve. Results: 58 cases were enrolled. The overall ASR was 14.1 per million. Males and females were equally affected. The peak incidence was for 15-19 year-olds in both sexes (ASR=10.4 per million in males and 8.5 in females). The 5-year overall survival rate was 27.6% (95% CI: 15.8-40.8%). The median survival time was 1.6 years (95% CI: 1.2-2.1). In a subgroup analysis, the patients who received only chemotherapy survived longer (5-year survival 45.7%, median survival time 4.1 years, p=0.12). Conclusion: The incidence rate for childhood osteosarcoma was slightly less than those reported for Western countries. The survival rate was also lower than reports from developed countries. Further evaluation of the treatment protocol and risk factor stratification is needed.

      • Incidences, Trends and Long Term Outcomes of Retinoblastoma in Three Cancer Registries, Thailand

        Wongmas, Piyathida,Jetsrisuparb, Arunee,Komvilaisak, Patcharee,Suwanrungruang, Krittika,Choeyprasert, Worawut,Sriplung, Hutcha,Wiangnon, Surapon Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.16

        Background: Retinoblastoma (RB) is rare, albeit the most common primary intraocular malignancy among children. To elucidate the true incidence, trend and survival, we studied incidences and trends of retinoblastoma in a large population with long-term follow-up using data from 3 population-based cancer registries. Objective: To describe the incidence, trends and survival of RB between 1990 and 2009 in Khon Kaen, Songkhla and Chiang Mai, Thailand. Materials and Methods: We sourced the data from the cancer registries in Khon Kaen, Songkhla and Chiang Mai on children with retinoblastoma, diagnosed between 1990 and 2009. Retinoblastoma was defined as per the International Classification of Disease for Oncology version 3 using the code 9510/3. Incidence was analyzed using the standard method with the criteria of the International Association of Cancer Registries. The Kaplan-Meier method was applied to calculate cumulative survival. Trends were calculated using the log rank test. Results: We identified 75 cases of children between 0 and 15 years of age diagnosed with RB (Khon Kaen 31, Chiang Mai 20, Songkhla 24). Males and females were equally affected. The most common age group was 0-4 years. The morphological verification of the disease was 90.7%. The respective ASR in Khon Kaen, Chiang Mai and Songkhla was 4.4, 4.0 and 4.6 per million; for which the overall ASR for all 3 areas was 4.3 per million. The respective trend in incidence was 4, 2.8, 5.8 and 5.4 during 1990-4, 1995-9, 2000-4 and 2005-9. Overall, incidence trended gradually upward by 2% annually. The respective survival rate in Khon Kaen, Chiang Mai and Songkhla was 50, 40 and 75% (differences not significantly different at p=0.14) and the overall survival for all centers was 60%. Conclusions: Over the last two decades, the incidence and overall survival of retinoblastoma has increased. The ASRs and survival in Thailand were less than those in resource-rich countries.

      • Trends in Survival of Childhood Cancers in a University Hospital, Northeast Thailand, 1993-2012

        Wongmeerit, Phunnipit,Suwanrungruang, Krittika,Jetsrisuparb, Arunee,Komvilaisak, Patcharee,Wiangnon, Surapon Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.7

        Background: In Thailand, a national treatment protocol for childhood leukemia and lymphoma (LL) was implemented in 2006. Access to treatment has also improved with the National Health Security system. Since these innovations, survival of childhood LL has not been fully described. Materials and Methods: Trends and survival of children under 15 with childhood cancers diagnosed between 1993 and 2012 were investigated using the hospital-based data from the Khon Kaen Cancer Registry, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand. Childhood cancers were classified into 12 diagnostic groups, according to the ICCC based on the histology of the cancer. Survival rates were described by period, depending on the treatment protocol. For leukemias and lymphomas, survival was assessed for 3 periods (1993-99, 2000-5, 2006-12) while for solid tumors it was for 2 periods (before and after 2000). The impacts of sex, age, use of the national protocol, and catchment area on leukemia and lymphoma were evaluated. Overall survival was calculated using the Kaplan-Meier method while the Cox proportional hazard model was used for multivariate analysis. Trends were calculated using the R program. Results: A total of 2,343 childhood cancer cases were included. Survival for acute lymphoblastic leukemia (ALL) from 1993-9, 2000-5, and 2006-12 improved significantly (43.7%, 64.6%, and 69.9%). This was to a lesser extent true for acute non-lymphoblastic leukemia (ANLL) (28.1%, 42.0%, and 42.2%). Survival of non-Hodgkin lymphoma (NHL) also improved significantly (44%, 65.5%, and 86.8%) but not for Hodgkin disease (HD) (30.1%, 66.1%, and 70.6%). According to multivariate analysis, significant risk factors associated with poor survival in the ALL group were age under 1 and over 10 years, while not using the national protocol had hazard ratios (HR) of 1.6, 1.3, and 2.3 respectively. In NHL, only non-use of national protocols was a risk factor (HR 3.9). In ANLL and HD, none of the factors influenced survival. Survival of solid tumors (liver tumors, retinoblastomas) were significantly increased compared to after and before 2000 while survival for CNS tumors, neuroblastoma and bone tumors was not changed. Conclusions: The survival of childhood cancer in Thailand has markedly improved. Since implementation of national protocols, this is particularly the case for ALL and NHL. These results may be generalizable for the whole country.

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