Brice Fresneau, Monique Fabre, François Janot, Martin Schlumberger, Olivier Caron, Nathalie Gaspar, Dominique Valteau-Couanet and Laurence Brugières
Purpose: In adolescents, carcinomas are rare tumors, accounting for 15% to 20% of cancers, with a wide spectrum.
Methods: Report of clinical, pathological and genetic characteristics of patients aged 12 to 18 years treated at Gustave Roussy for a carcinoma from 1990 to 2009.
Results: 204 adolescents, sex ratio F/M: 140/64, median age 16 years, were identified. Main sites were thyroid (40%, with 67/82 papillary carcinomas) and nasopharynx (20%). Five-year OS and EFS of the whole cohort were respectively 75% (95%CI 0.68-0.80) and 64% (95%CI 0.57-0.71). We identified three risk groups: (1) thyroid and salivary gland carcinomas (5-y OS 100%), (2) nasopharyngeal undifferentiated carcinomas and genital carcinomas (5-y OS 80%), (3) others such as hepatocellular carcinomas, renal carcinomas and squamous cell carcinomas of the oral cavity (5-y OS 24%). A genetic predisposition to cancer was identified in only 9/204 adolescents.
Conclusion: Thyroid and nasopharyngeal carcinomas are the most frequent sites and carry a good prognosis whereas squamous cell carcinomas of the oral cavity, hepatocellular carcinomas and non-localized renal carcinomas mostly portend a fatal outcome. International collaborative research between pediatric and medical oncologists is needed to improve the prognosis and to better understand the genetic determinants of these tumors with an unusual onset during adolescence.
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