{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:50:53Z","timestamp":1777693853944,"version":"3.51.4"},"reference-count":43,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"8","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2023,3,10]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> To describe the risk of late mortality, subsequent malignant neoplasms (SMNs), and chronic health conditions (CHCs) in survivors of neuroblastoma diagnosed in infancy by treatment era and exposures. <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p> Among 5-year survivors of neuroblastoma in the Childhood Cancer Survivor Study diagnosed age &lt; 1 year between 1970 and 1999, we examined the cumulative incidence of late (&gt; 5 years from diagnosis) mortality, SMN, and CHCs (grades 2-5 and 3-5). Multivariable Cox regression models estimated hazard ratios (HRs) and 95% CIs by decade and treatment (surgery-alone v chemotherapy with or without surgery [C \u00b1 S] v radiation with or without chemotherapy \u00b1 surgery [R \u00b1 C \u00b1 S]) among survivors and between survivors and 5,051 siblings. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> Among 1,397 eligible survivors, the 25-year cumulative incidence of late mortality was 2.1% (95% CI, 1.3 to 3.9) with no difference by treatment era. Among 990 participants who completed a baseline survey, fewer survivors received radiation in more recent eras (51.2% 1970s, 20.4% 1980s, and 10.1% 1990s; P &lt; .001). Risk of SMN was elevated only among individuals treated with radiation-containing regimens compared with surgery alone (HR<jats:sub>[C \u00b1 S]<\/jats:sub>, 3.2 [95% CI, 0.9 to 11.6]; HR<jats:sub>[R \u00b1 C \u00b1 S]<\/jats:sub>, 5.7 [95% CI, 1.2 to 28.1]). In adjusted models, there was a 50% reduction in risk of grade 3-5 CHCs in the 1990s versus 1970s (HR, 0.5 [95% CI, 0.3 to 0.9]; P = .01); individuals treated with radiation had a 3.6-fold risk for grade 3-5 CHCs (95% CI, 2.1 to 6.2) versus those treated with surgery alone. When compared with siblings, risk of grade 3-5 CHCs for survivors was lowest in the most recent era (HR<jats:sub>[1970s]<\/jats:sub>, 4.7 [95% CI, 3.4 to 6.5]; HR<jats:sub>[1980s]<\/jats:sub>, 4.6 [95% CI, 3.3 to 6.4]; HR<jats:sub>[1990s]<\/jats:sub>, 2.5 [95% CI, 1.7 to 3.9]). <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> Neuroblastoma survivors treated during infancy have a relatively low absolute burden of late mortality and SMN. Encouragingly, risk of CHCs has declined in more recent eras with reduced exposure to radiation therapy. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.22.01732","type":"journal-article","created":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T21:00:15Z","timestamp":1671224415000},"page":"1565-1576","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":9,"title":["Long-Term Morbidity and Mortality Among Survivors of Neuroblastoma Diagnosed During Infancy: A Report From the Childhood Cancer Survivor Study"],"prefix":"10.1200","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4668-9176","authenticated-orcid":false,"given":"Danielle Novetsky","family":"Friedman","sequence":"first","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"Weill Cornell Medical College, New York, 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