Anthropometric trends in survivors of pediatric solid tumors

Abstract

Background: The importance of nutritional status in pediatric oncology cannot be overemphasized, not only due to its potential impact on the disease, but also for its impact on their survivorship. We sought to evaluate the arthropometric trends in pediatric solid tumor survivors Methods: The study included a cohort of Hepatoblastoma(HB), Wilms Tumor (WT) and Malignant Germ Cell tumors(MGCT) survivors registered at pediatric surgical-oncology clinic from 1994 to 2016. Anthropometry was noted at the time of presentation, after completion of chemotherapy, and at last follow-up. The z-scores for weight-for-age and height-for-age were calculated using WHO growth charts for age <5 years and IAP growth charts for age >/= 5 years Results: Of the survivors, 317 survivors, comprising of 48, 81 and 188 survivors of HB, MGCT and WT respectively, were included in the analysis. The median age at diagnosis was 24.5(IQR 59-13.2) months, with range of 5-19.54years of follow-up. On evaluating the z-scores of the collective cohort of survivors at three time points, we found that the z-scores for height for age, weight for age and BMI showed an improving trend in nutrition. The difference in the prevalence of malnutrition and severe malnutrition was found to be statistically significant when any two time points were compared during follow-up (p<0.05). A similar trend was seen in the individual cohorts of HB, MGCT and WT, which showed 10% and 7.5%, 10.9% and 9%, 15.7% and 11.4% to be stunted and wasted at last follow-up. We found no significant effect of age at diagnosis on the anthropometric measures at last follow-up. On evaluating BMI in 28 adult survivors, we found 43% to be in the underweight category. Conclusions: Anthrometric measures improve during follow-up, however, up-to 15% children persist being malnourished which is close to the national averages. Thus, the effect of therapy improves over time.