Risk of late health effects after soft-tissue sarcomas in childhood–a population-based cohort study within the Adult Life after Childhood Cancer in Scandinavia research programme

Research output: Contribution to journalArticle


Background: In the 1960s only 1/3 of children with soft-tissue sarcomas survived, however with improved treatments survival today has reached 70%. Given the previous poor survival and the rarity of soft-tissue sarcomas, the risk of somatic late effects in a large cohort of Nordic soft-tissue sarcoma survivors has not yet been assessed. Methods: In this population-based cohort study we identified 985 five-year soft-tissue sarcoma survivors in Nordic nationwide cancer registries and late effects in national hospital registries covering the period 1964–2012. Information on tumour site and radiotherapy was available for Danish and Finnish survivors (N = 531). Using disease-specific rates of first-time hospital contacts for somatic diseases in survivors and in 4,830 matched comparisons we calculated relative rates (RR) and rate differences (RD). Results: Survivors had a RR of 1.5 (95% CI 1.4–1.7) and an absolute RD of 23.5 (17.7–29.2) for a first hospital contact per 1,000 person-years. The highest risks in both relative and absolute terms were of endocrine disorders (RR = 2.5; RD = 7.6), and diseases of the nervous system (RR = 1.9; RD = 6.6), digestive organs (RR = 1.7; RD = 5.4) and urinary system (RR = 1.7; RD = 5.6). By tumour site, excess risk was lower after extremity tumours. Irradiated survivors had a 2.6 (1.2–5.9) times higher risk than non-irradiated. Conclusions: Soft-tissue sarcoma survivors have an increased risk of somatic late effects in 5 out of 10 main diagnostic groups of diseases, and the risk remains increased up to 40 years after cancer diagnosis. Risks were slightly lower for those treated for tumours in the extremities, and radiotherapy increased the risk by more than two-fold.


  • Filippa Nyboe Norsker
  • Cristina Boschini
  • Catherine Rechnitzer
  • Anna Sällfors Holmqvist
  • Laufey Tryggvadottir
  • Laura Maria Madanat-Harjuoja
  • Henrik Schrøder
  • Thomas H. Scheike
  • Henrik Hasle
  • Jeanette Falck Winther
  • Klaus Kaae Andersen
  • ALiCCS study group
External organisations
  • Danish Cancer Society Research Center
  • University of Copenhagen
  • Copenhagen University Hospital
  • Skåne University Hospital
  • Icelandic Cancer Registry
  • University of Iceland
  • Finnish Cancer Registry
  • Harvard University
  • Aarhus University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Pediatrics
Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalActa Oncologica
Issue number10
Publication statusPublished - 2020
Publication categoryResearch