Late hepatotoxicity after treatment for childhood cancer

Abstract

Contemporary treatment approaches have resulted in excellent cure rates for childhood cancer; however, these therapeutic advances are accompanied by adverse, long-term health outcomes, commonly referred to as late effects. Among these, late hepatic toxicity remains an underrecognized yet potentially serious consequence. Unlike acute liver injury, long-term hepatotoxicity often develops insidiously, with potential progression to severe morbidity or even life-threatening conditions. This review focuses on late hepatic adverse effects in childhood cancer survivors, highlighting the role of specific therapeutic exposures that compromise liver health. Early identification, monitoring, and timely intervention are essential to mitigate risk. Furthermore, long-term, multidisciplinary follow-up remains critical to improve quality of life in this growing population of survivors. Greater awareness and dedicated research are needed to address the burden of late therapy-related liver complications and to optimize survivorship care.

Keywords: Childhood cancer; Survivors; Late effects; Liver disease; Hepatotoxicity

Core Tip: Modern treatment regimens have markedly improved survival rates in children with cancer. However, these advances are accompanied by the risk of long-term health complications, collectively termed late effects. Among these, late hepatic toxicity remains under-investigated despite its potential to cause subtle, progressive, and even life-threatening liver damage. Given the silent nature of liver involvement, ongoing multidisciplinary follow-up of childhood cancer survivors is crucial for early detection, prevention, and timely intervention.