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J Neurooncol. 2017 Jan;131(1):163-175. doi: 10.1007/s11060-016-2284-9. Epub 2016 Oct 14.

Incidence, time trends and survival patterns of childhood pilocytic astrocytomas in Southern-Eastern Europe and SEER, US.

Author information

1
Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Mikras Asias 75, 11527, Athens, Greece.
2
National Cancer Registry of Ukraine, National Institute of Cancer, Lomonosova str 33/43, Kyiv, 03022, Ukraine.
3
Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Childhood Cancer Subregistry of Belarus, Lesnoe-2, 223040, Minsk, Belarus.
4
Bulgarian National Cancer Registry, National Oncology Hospital, 6 Plovdivsko Pole Street, 1756, Sofia, Bulgaria.
5
Izmir Cancer Registry, Izmir Hub, Izmir & Hacettepe University Institute of Public Health, Zubeyde Hanim Caddesi No: 100, Karsiyaka, 35067, Izmir, Turkey.
6
North Region Cancer Registry of Portugal (RORENO), Portuguese Oncology Institute of Porto, Rua António Bernardino da Almeida, 4200-072, Porto, Portugal.
7
Croatian National Cancer Registry, Croatian Institute of Public Health, Rockefellerova 7, 10000, Zagreb, Croatia.
8
Cancer Registry of Republic of Slovenia, Institute of Oncology, Zaloška cesta 2, 1000, Ljubljana, Slovenia.
9
Central Region Cancer Registry of Portugal (ROR-Centro), Portuguese Oncology Institute of Coimbra, Av. Bissaya Barreto 98, 3000-075, Coimbra, Portugal.
10
Department of Health Information and Research, Malta National Cancer Registry, 95 Guardamangia Hill, Guardamangia, MSD 08, Malta.
11
Regional Cancer Registry of Iasi, National Institute of Public Health, 14 Victor Babes Street, 700465, Iasi, Romania.
12
Regional Cancer Registry of Cluj, Oncological Institute "Ion Chiricuta", Republicii Str no. 34-36, 400015, Cluj Napoca, Romania.
13
First Department of Radiology, Aretaieion Hospital, Medical School, University of Athens, Vasilissis Sofias Str. 76, 11528, Athens, Greece.
14
Oncology Department, "Mitera" Childrens Hospital, Erythrou Stavrou 15, 15123, Marousi, Athens, Greece.
15
Second Department of Pediatrics, AHEPA General Hospital, Aristotelion University of Thessaloniki, Kiriakidi 1, 54621, Thessaloniki, Greece.
16
Haematology-Oncology Unit, First Department of Pediatrics, Athens University Medical School, "Aghia Sophia" Children's Hospital, Thivon and Papadiamantopoulou, 11527, Athens, Greece.
17
Department of Pathology, Hygeia Hospital, Erythrou Stavrou 6, 15123, Marousi, Athens, Greece.
18
Department of Neurosurgery, "Aghia Sophia" Children's Hospital, Thivon and Papadiamantopoulou, 11527, Athens, Greece.
19
Department of Pediatric Hematology and Oncology, Hippokration Hospital, Konstantinoupoleos 49, 54642, Thessaloniki, Greece.
20
Department of Pediatric Haematology-Oncology, "Aghia Sophia" Children's Hospital, Thivon and Papadiamantopoulou, 11527, Athens, Greece.
21
Department of Neurosurgery, "Mitera" Childrens Hospital, Erythrou Stavrou 15, 15123, Marousi, Athens, Greece.
22
Histopathology Department, "Aghia Sophia" Children's Hospital, Thivon and Papadiamantopoulou, 11527, Athens, Greece.
23
Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Panepistimiou, 71500, Heraklion, Greece.
24
Histopathology Department, "Pan. & Agl. Kyriakou" Children's Hospital, Thivon 18, 11527, Athens, Greece.
25
Department of Neurosurgery, St. Luke's Hospital, Panorama, 55236, Thessaloniki, Greece.
26
Department of Pediatric Hematology-Oncology, "Pan. & Agl. Kyriakou" Children's Hospital, Thivon 18, 11527, Athens, Greece.
27
Department of Pathology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527, Athens, Greece.
28
Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Mikras Asias 75, 11527, Athens, Greece. epetrid@med.uoa.gr.

Abstract

Pilocytic astrocytomas (PA) comprise the most common childhood central nervous system (CNS) tumor. Exploiting registry-based data from Southern and Eastern Europe (SEE) and SEER, US, we opted to examine incidence, time trends, survival and tentative outcome disparities of childhood PA by sociodemographic and clinical features. Childhood PA were retrieved from 12 SEE registries (N = 552; 1983-2014) and SEER (N = 2723; 1973-2012). Age-standardized incidence rates (ASR) were estimated and survival was examined via Kaplan-Meier and Cox regression analysis. ASR of childhood PA during 1990-2012 in SEE was 4.2/106, doubling in the USA (8.2/106). Increasing trends, more prominent during earlier registration years, were recorded in both areas (SEE: +4.1 %, USA: +4.6 %, annually). Cerebellum comprised the most common location, apart from infants in whom supratentorial locations prevailed. Age at diagnosis was 1 year earlier in SEE, whereas 10-year survival was 87 % in SEE and 96 % in SEER, improving over time. Significant outcome predictors were age <1 year at diagnosis diagnosis (hazard ratio, HR [95% confidence intervals]: 3.96, [2.28-6.90]), female gender (HR: 1.38, [1.01-1.88]), residence in SEE (HR: 4.07, [2.95-5.61]) and rural areas (HR: 2.23, [1.53-3.27]), whereas non-cerebellar locations were associated with a 9- to 12-fold increase in risk of death. The first comprehensive overview of childhood PA epidemiology showed survival gains but also outcome discrepancies by geographical region and urbanization pointing to healthcare inequalities. The worse prognosis of infants and, possibly, females merits further consideration, as it might point to treatment adjustment needs, whereas expansion of systematic registration will allow interpretation of incidence variations.

KEYWORDS:

CNS tumors; Cancer registries; Childhood; Incidence; Pilocytic astrocytomas; Survival

PMID:
27743145
DOI:
10.1007/s11060-016-2284-9
[Indexed for MEDLINE]

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