Background: Advances in cancer treatment have caused the population of childhood cancer survivors (CCSs) to increase. CCSs are at risk of multiple therapy-related late effects (LEs). This study aims to evaluate the LE incidence and to assess how the body mass index (BMI) evolved in a CCS cohort from a Brazilian tertiary center. Methods: Retrospective cohort study with CCSs who received chemotherapy, radiotherapy, or both, seen in a follow-up clinic from 2002 to 2017. Anthropometric and clinical data were analyzed as descriptive statistics and hypothesis tests. LE cases were defined according to specific guidelines and classified into grades 1 to 4. The Z-scores of the participants’ BMI at diagnosis, treatment completion, and the last appointment at the clinic were compared. Results: The final sample included 245 CCSs; the median ages at diagnosis and recruiting were 7 and 16 years, respectively; the median follow-up period was 8.5 years. The most frequent diagnoses were acute lymphoblastic leukemia, central nervous system (CNS) tumors, and lymphomas. The LE incidence was 53.8% and included overweight/obesity (36.6%), hearing loss (34%), and thyroid gland abnormalities (32.8%). Treatment for medulloblastoma, Ewing sarcoma, and CNS tumors led to the highest LE incidence. In 66% of the participants, LEs were mild or moderate. The prevalence of overweight and obese participants was 24.4% and 12.2%, respectively. After treatment, the Z-scores of the participants’ BMI tended to increase over time, particularly in the groups aged 5–9 and 10–19 years. Conclusion: The LE incidence resembled the incidence reported in previous studies.

Pediatric adrenocortical tumors (ACT) are rare aggressive neoplasms with heterogeneous prognosis. Despite extensive efforts, identifying reliable prognostic factors for pediatric patients with ACT remains a challenge. MicroRNA (miRNA) signatures have been associated with cancer diagnosis, treatment response, and prognosis of several types of cancer. However, the role of miRNAs has been poorly explored in pediatric ACT. In this study, we performed miRNA microarray profiling on a cohort of 37 pediatric ACT and nine non-neoplastic adrenal (NNA) samples and evaluated the prognostic significance of abnormally expressed miRNAs using Kaplan-Meier plots, log-rank test and Cox regression analysis. We identified a total of 98 abnormally expressed miRNAs, which expression profile discriminated ACT from NNAs. Among the 98 deregulated miRNAs, 17 presented significant associations with patients’ survival. In addition, higher expression levels of hsa-miR-630, -139-3p, -125a-3p, -574-5p, -596, -564, -1321, and -423-5p and lower expression levels of hsa-miR-377-3p, -126-3p, -410, -136-3p, -29b-3p, -29a-3p, -337-5p, -143-3p, and 140-5p were significantly associated with poor prognosis, tumor relapse, and/or death. Importantly, the expression profile of these 17 miRNAs stratified patients into two groups of ACTs with different clinical outcomes. Although some individual miRNAs exhibit potential prognostic values in ACTs, only the 17 miRNA-based expression clustering was considered an independent prognostic factor for five-year event-free survival (EFS) compared to other clinicopathological features. In conclusion, our study reports for the first time associations between miRNA profiles and childhood ACT prognosis, providing evidence that miRNAs could be useful biomarkers to discriminate patients with favorable and unfavorable clinical outcomes.