Survival in Childhood Malignancies: Assessment of the Influence of Age, Sex, and Tumor Type, With Emphasis on “Long-Term Survivors”

Survival data (or a 5-year period were analyzed for all newly diagnosed malignancies in Israel in children under 15. Three major survival patterns were evident: an extremely poor survivorship (or leukemia, a good survivorship (or retinoblastoma, and an intermediate position (or the rest of the tumor categories. Survival was appreciably affected by age and sex: With most types of neoplasms, particularly lymphomas, survival was consistently better in girls. The exceptions were patients with leukemia, in which survival was similar in both sexes, or with brain tumor, in which boys had considerably better survival. The tumor distribution was similar in both sexes. Median survival time increased gradually (rom the group under 1 year old to the 10- to 14-year-old group. This improvement with age was partly due to a shift toward tumors with better survivorship and partly to an increasing survival with age in each of the specific tumor types. In all tumor categories the probability of dying within a fixed time interval became progressively lower (or those surviving longer after diagnosis. Eventually, in all tumor types except leukemia, the annual probability of death among those who survived (or a certain time period dropped below 0.10 and probably considerably less in some categories. These patients are referred to as long-term survivors. The length of time from diagnosis after which survivors can be considered long-term, and the percentage of diagnosed cases likely to become long-term survivors, varied according to tumor type, sex, and age. The survival patterns observed indicate the existence of a variable disease course ranging from the very fulminant to the benign.