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The presence, severity, resolution, and treatment history of seizures were abstracted from medical records. Adjusting for the age at diagnosis, sex, and prior cancer therapy, multivariable models examined the impact of seizures on neurocognitive and HRQOL outcomes. Mediation analyses were conducted for social outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seizures were identified in 232 survivors (11.5%; 29.9% of survivors with central nervous system [CNS] tumors and 9.0% of those without CNS tumors). In CNS tumor survivors, seizures were associated with poorer executive function and processing speed (<jats:italic>P<\/jats:italic> &lt; .02); in non\u2010CNS tumor survivors, seizures were associated with worse function in every domain (<jats:italic>P<\/jats:italic> &lt; .05). Among non\u2010CNS survivors, seizure severity was associated with worse processing speed (<jats:italic>P<\/jats:italic> = .023), and resolution was associated with better executive function (<jats:italic>P<\/jats:italic> = .028) and attention (<jats:italic>P<\/jats:italic> = .044). In CNS survivors, seizure resolution was associated with improved attention (<jats:italic>P<\/jats:italic> = .047) and memory (<jats:italic>P<\/jats:italic> &lt; .02). Mediation analysis revealed that the impact of seizures on social outcomes was mediated by neurocognitive function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Seizures in cancer survivors adversely affect long\u2010term functional and psychosocial outcomes independently of cancer therapy. The resolution of seizure occurrence is associated with better outcomes. Seizure severity is associated with poorer outcomes and should be a focus of clinical management and patient education.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33879","type":"journal-article","created":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T11:28:12Z","timestamp":1630495692000},"page":"180-191","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Seizures' impact on cognition and quality of life in childhood cancer survivors"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2021-4036","authenticated-orcid":false,"given":"Nicholas S.","family":"Phillips","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja B.","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Neurology St. Jude 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