Metabolic syndrome in childhood, adolescent, and young adult cancer survivors: recommendations for surveillance from the International Late Effects of Childhood Cancer Guideline Harmonization Group.
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van den Oever Selina R, Mulder Renée L, Oeffinger Kevin C, Gietema Jourik A, Skinner Roderick, Constine Louis S, Wallace W Hamish, Armenian Saro, Barnea Dana, Bardi Edit, Belle Fabiën N, Brown Austin L, Chemaitilly Wassim, Crowne Liz, van Dalen Elvira C, Denzer Christian, Ehrhardt Matthew J, Felicetti Francesco, Friedman Danielle N, Fulbright Joy, Glaser Adam W, Giwercman Aleksander, Sangstuen Haugnes Hege, Hayek Samah, Hennewig Ulrike, van den Heuvel-Eibrink Marry M, Haupt Riccardo, van Iersel Laura, Kamdar Kala, Lefrandt Joop, Levitt Gill, Morsellino Vera, Mulrooney Daniel A, Murray Robert D, Neggers Sebastian, Ness Kirsten K, Neville Kristen A, Nock Nora L, Otth Maria, Prasad Pinki K, van Santen Hanneke M, Schindera Christina, Rath Shoshana R, Steinberger Julia, Terenziani Monica, Varedi Mitra, Walwyn Thomas, Wei Christina, Hudson Melissa M, Kremer Leontien C M, Nuver Janine, Tonorezos Emily
Аннотация
DESIGN: Systematic review and guideline development.
METHODS: A multidisciplinary guideline panel evaluated concordances and discordances across national guidelines for MetS surveillance and performed a systematic literature review. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to grade the available evidence and formulate recommendations considering the strength of the underlying evidence as well as potential harms and benefits associated with MetS surveillance. In case evidence was lacking, recommendations were based on expert opinion. In addition, recommendations for surveillance modalities were derived from existing guidelines for MetS components where applicable.
RESULTS: The systematic literature review included 20 studies and highlighted 2 high-risk groups, namely CAYA cancer survivors treated with total body irradiation and those treated with cranial or craniospinal irradiation (moderate-quality evidence). Recommendations were formulated for MetS surveillance in these risk groups, covering preferred screening modalities, age at screening initiation, and surveillance frequency.
CONCLUSIONS: In this international surveillance guideline for MetS in CAYA cancer survivors, we provide evidence-based recommendations for clinical practice, with the aim of ensuring optimal MetS surveillance for CAYA cancer survivors.