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Paediatric genitourinary cancers and late effects of treatment

Nature Reviews Urology volume 10, pages 15–25 (2013)Cite this article

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Abstract

The most common childhood genitourinary cancers are Wilms tumour, rhabdomyosarcoma and germ cell tumour (GCT). Long-term survival rates for patients with these tumours are generally excellent, ranging from 80% to 100%. However, the high cure rates have highlighted the need to minimize the long-term complications of treatments (referred to as 'late effects'), which can be caused by the three treatment modalities used to treat genitourinary tumours: surgery, chemotherapy and radiation therapy. Serious late effects, such as death, second cancers and tumour recurrence, are uncommon but do occur occasionally. Chronic health conditions—such as cardiac, pulmonary and fertility disorders—are more prevalent. Given the high prevalence of late effects, survivors of childhood genitourinary malignancies require regular surveillance and health promotion delivered by health-care providers with specialist knowledge of the long-term complications of treatment.

Key Points

  • Overall survival rates for children with Wilms tumour, genitourinary rhabdomyosarcoma and gonadal germ cell tumours are 80–100%

  • Serious late effects, such as death, second malignancies and recurrence are uncommon in survivors of genitourinary cancers, but chronic health conditions often arise

  • Given the high incidence and prevalence of late effects, survivors of childhood genitourinary malignancies require regular disease surveillance and health promotion delivered by healthcare providers knowledgeable in this area

  • Continued research is needed to understand the mechanisms of late effects and to, therefore, reduce long-term complications from treatments of childhood genitourinary malignancies

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Figure 1: Genitourinary cancers of childhood.
Figure 2: Potential late effects from Wilms tumour treatment.
Figure 3: Potential late effects from rhabdomyosarcoma treatment.
Figure 4: Potential late effects from germ cell tumour treatment.

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Author information

Authors and Affiliations

  1. Division of Oncology, Children's National Medical Center, 111 Michigan Avenue NW, 20010, Washington, DC, USA

    Karim T. Sadak & Jeffrey S. Dome

  2. Department of Surgery, Phoenix Children's Hospital, 1919 East Thomas Road, Phoenix, 85016, AZ, USA

    Michael L. Ritchey

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  1. Karim T. Sadak
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  2. Michael L. Ritchey
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K. T. Sadak and J. S. Dome made substantial contributions to discussions of content and reviewed and edited the manuscript before submission. All authors researched data for the article and wrote the manuscript.

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Correspondence to Jeffrey S. Dome.

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Sadak, K., Ritchey, M. & Dome, J. Paediatric genitourinary cancers and late effects of treatment. Nat Rev Urol 10, 15–25 (2013). https://doi.org/10.1038/nrurol.2012.218

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