Abstract
Background
Congenital (< 3 months) and infant (3 to 11 months) brain tumors are biologically different from tumors in older children, but their epidemiology has not been studied comprehensively. Insight into epidemiological differences could help tailor treatment recommendations by age and increase overall survival (OS).
Methods
Population-based data from SEER were obtained for 14,493 0–19-year-olds diagnosed with CNS tumors 1990–2015. Congenital and infant age groups were compared to patients aged 1–19 years based on incidence, treatment, and survival using Chi-square and Kaplan–Meier analyses. Hazard ratios were estimated from univariate and multivariable Cox proportional hazards survival analyses.
Results
Between the < 3-month, 3–5-month, 6–11 month, and 1–19-year age groups, tumor type distribution differed significantly (p < 0.001). 5-year OS for all tumors was 36.7% (< 3 months), 56.0% (< 3–5 months), 63.8% (6–11 months), and 74.7% (1–19 years) (p < 0.001). Comparing between age groups by tumor type, OS was worst for < 3-month-olds with low-grade glioma, medulloblastoma, and other embryonal tumors; OS was worst for 3–5-month-olds with ependymoma, < 1-year-olds collectively with atypical teratoid-rhabdoid tumor, and 1–19-year-olds with high-grade glioma (HGG) (log rank p < 0.02 for all tumor types). Under 3-month-olds were least likely to receive any treatment for each tumor type and least likely to undergo surgery for all except HGG. Under 1-year-olds were far less likely than 1–19-year-olds to undergo both radiation and chemotherapy for embryonal tumors.
Conclusions
Subtype distribution, treatment patterns, and prognosis of congenital/infant CNS tumors differ from those in older children. Better, more standardized treatment guidelines may improve poorer outcomes seen in these youngest patients.
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Data availability
All data analyzed for this study is included in main tables, figures, and supplemental tables.
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Acknowledgements
This work was supported in part by the Population Health Shared Resource of the University of Colorado Cancer Center support Grant P30CA046934. ALG is supported by a career development award from NINDS (1K08 NS102532-01) and the Luke’s Army Pediatric Cancer Research Fund St. Baldrick’s Scholar Award. A version of this project was presented at the 2020 International Symposium on Pediatric Neuro-Oncology (ISPNO).
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ALG conceived and designed the study. MH and AB led data gathering. MH, AB, AAM, and ALG performed data analysis, with population data analysis expertise provided by AAM. AG assisted with neuropathological classification of tumor groups. MH led manuscript preparation, and all authors assisted with writing and approved the final version.
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Hart, M., Anderson-Mellies, A., Beltrami, A. et al. Population-based analysis of CNS tumor diagnoses, treatment, and survival in congenital and infant age groups. J Neurooncol 157, 333–344 (2022). https://doi.org/10.1007/s11060-022-03967-z
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DOI: https://doi.org/10.1007/s11060-022-03967-z