{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T17:50:25Z","timestamp":1789235425579,"version":"build-2803163510"},"reference-count":64,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"2","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2025,1,10]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE<\/jats:title>\n            <jats:p>Neuroblastoma survivors have an increased risk of developing subsequent malignant neoplasms (SMNs), but the risk of subsequent nonmalignant neoplasms (SNMNs) and risk factors are largely unknown. We analyzed the long-term risks and associated risk factors for developing SMNs and SNMNs in a well-characterized cohort of 5-year neuroblastoma survivors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>We included 563 5-year neuroblastoma survivors from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort, diagnosed during 1963-2014. Subsequent neoplasms were ascertained by linkages with the Netherlands Cancer Registry and the Dutch Nationwide Pathology Databank (Palga) and medical chart review. We calculated standardized incidence ratios (SIRs), absolute excess risk (AER), and cumulative incidences. Multivariable competing risk regression analysis was used to evaluate risk factors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>\n              In total, 23 survivors developed an SMN and 60 an SNMN. After a median follow-up of 23.7 (range, 5.0-56.3) years, the risk of SMN was elevated compared with the general population (SIR, 4.0; 95% CI, 2.5 to 5.9; AER per 10,000 person-years, 15.1). The 30-year cumulative incidence was 3.4% (95% CI, 1.9 to 6.0) for SMNs and 10.4% (95% CI, 7.3 to 14.8) for SNMNs. Six survivors developed an SMN after iodine-metaiodobenzylguanidine (\n              <jats:sup>131I<\/jats:sup>\n              MIBG) treatment. Survivors treated with\n              <jats:sup>131I<\/jats:sup>\n              MIBG had a higher risk of developing SMNs (subdistribution hazard ratio [SHR], 5.7; 95% CI, 1.8 to 17.8) and SNMNs (SHR, 2.6; 95% CI, 1.2 to 5.6) compared with survivors treated without\n              <jats:sup>131I<\/jats:sup>\n              MIBG; results for SMNs were attenuated in high-risk patients only (SMNs SHR, 3.6; 95% CI, 0.9 to 15.3; SNMNs SHR, 1.5; 95% CI, 0.7 to 3.6).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>\n              Our results demonstrate that neuroblastoma survivors have an elevated risk of developing SMNs and a high risk of SNMNs.\n              <jats:sup>131I<\/jats:sup>\n              MIBG may be a treatment-related risk factor for the development of SMN and SNMN, which needs further validation. Our results emphasize the need for awareness of subsequent neoplasms and the importance of follow-up care.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1200\/jco.23.01430","type":"journal-article","created":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T19:59:16Z","timestamp":1727899156000},"page":"154-166","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":3,"title":["Long-Term Risk of Subsequent Neoplasms in 5-Year Survivors of Childhood Neuroblastoma: A Dutch Childhood Cancer Survivor Study-LATER 3 Study"],"prefix":"10.1200","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3215-8964","authenticated-orcid":true,"given":"Aim\u00e9e S.R.","family":"Westerveld","sequence":"first","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4452-0748","authenticated-orcid":true,"given":"Godelieve A.M.","family":"Tytgat","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6773-6931","authenticated-orcid":true,"given":"Hanneke M.","family":"van Santen","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"},{"name":"Department of Pediatric Endocrinology, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0503-5838","authenticated-orcid":true,"given":"Max M.","family":"van Noesel","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"},{"name":"Department of Imaging &amp; Cancer, University Medical Center Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9963-8367","authenticated-orcid":true,"given":"Jacqueline","family":"Loonen","sequence":"additional","affiliation":[{"name":"Department of Hematology, Radboudumc Center of Expertise for Cancer Survivorship, Radboud University Medical Center, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0964-0007","authenticated-orcid":true,"given":"Andrica C.H.","family":"de Vries","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"},{"name":"Netherlands Department of Pediatric Oncology\/Hematology, Erasmus Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marloes","family":"Louwerens","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria M.W.","family":"Koopman","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5767-854X","authenticated-orcid":true,"given":"Margriet","family":"van der Heiden-van der Loo","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert O.","family":"Janssens","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"},{"name":"Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6871-1296","authenticated-orcid":true,"given":"Ronald R.","family":"de Krijger","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"},{"name":"Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3524-4657","authenticated-orcid":true,"given":"Cecile M.","family":"Ronckers","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"},{"name":"Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics Informatics and Epidemiology, University Medical Center of the JGU, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2253-2115","authenticated-orcid":true,"given":"Helena J.H.","family":"van der Pal","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leontien C.M.","family":"Kremer","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"},{"name":"University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, the Netherlands"},{"name":"Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2647-2677","authenticated-orcid":true,"given":"Jop C.","family":"Teepen","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30186-9"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.05.571"},{"key":"e_1_3_7_4_2","unstructured":"IKNL: Nederlandse Kankerregistratie (NKR). iknl.nl\/nkr-cijfers"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0804577"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.78"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.22827"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djp230"},{"key":"e_1_3_7_9_2","first-page":"107","article-title":"Late effects and survivorship issues in patients with neuroblastoma","volume":"5","author":"Friedman DN","year":"2018","unstructured":"Friedman DN, Henderson TO: Late effects and survivorship issues in patients with neuroblastoma. 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