TP53 and cancer: Li-Fraumeni syndrome is associated with a high lifetime-risk of cancer, and the risk of a secondary cancer is further increased when the first cancer occurs during childhood.[58,59] Data suggest that surveillance programs for Li-Fraumeni patients increase their survival rates.[60] However, in contrast to other studies, patients with Li-Fraumeni syndrome were not identified here.[8,16] A possible explanation is that one of our patients carried a de novo TP53 variant that could not be identified from a family history of cancer.