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J Neurooncol. 2020 Mar 3. doi: 10.1007/s11060-020-03437-4. [Epub ahead of print]

Clinical presentation of young people (10-24 years old) with brain tumors: results from the international MOBI-Kids study.

Author information

1
ISGlobal, Barcelona, Spain.
2
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
3
Ciber Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
4
Center for Public Health, Department of Environmental Health, Medical University Vienna, Vienna, Austria.
5
IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
6
Ciber Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. alguacil@dbasp.uhu.es.
7
Environmental Epidemiology and Neuroscience Laboratory, RENSMA, Huelva University, Av. Andalucía s/n, E-21071, Huelva, Spain. alguacil@dbasp.uhu.es.
8
Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
9
Clinical Epidemiology Unit Karolinska Institutet, Stockholm, Sweden.
10
Área de Medicina Preventiva y Salud Pública, Universitat de Valencia, Valencia, Spain.
11
Public Health Services, Ministry of Health, Tel Aviv, Israel.
12
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
13
Environmental and Occupational Epidemiology Branch, Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research Prevention and Clinical Network-ISPRO, Florence, Italy.
14
Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India.
15
Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
16
Scientific Director's Office, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
17
Institute of Neurology, Medical University Vienna, Vienna, Austria.
18
Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy.
19
Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany.
20
School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
21
Centre for Public Health Research, Massey University, Wellington, New Zealand.
22
French National Registry of Childhood Solid Tumors, CHU, Nancy, France.
23
Inserm, Center of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris University, Paris, France.
24
Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
25
Population Oncology, BC Cancer, Vancouver, Canada.
26
School of Population and Public Health, University of British Columbia, Vancouver, Canada.
27
School of Kinesiology and Health Science and Department of Psychology, York University, Toronto, Canada.
28
Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan.
29
Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, South Korea.
30
Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
31
University of Ottawa, Ottawa, ON, Canada.
32
Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.

Abstract

INTRODUCTION:

We used data from MOBI-Kids, a 14-country international collaborative case-control study of brain tumors (BTs), to study clinical characteristics of the tumors in older children (10 years or older), adolescents and young adults (up to the age of 24).

METHODS:

Information from clinical records was obtained for 899 BT cases, including signs and symptoms, symptom onset, diagnosis date, tumor type and location.

RESULTS:

Overall, 64% of all tumors were low-grade, 76% were neuroepithelial tumors and 62% gliomas. There were more males than females among neuroepithelial and embryonal tumor cases, but more females with meningeal tumors. The most frequent locations were cerebellum (22%) and frontal (16%) lobe. The most frequent symptom was headaches (60%), overall, as well as for gliomas, embryonal and 'non-neuroepithelial' tumors; it was convulsions/seizures for neuroepithelial tumors other than glioma, and visual signs and symptoms for meningiomas. A cluster analysis showed that headaches and nausea/vomiting was the only combination of symptoms that exceeded a cutoff of 50%, with a joint occurrence of 67%. Overall, the median time from first symptom to diagnosis was 1.42 months (IQR 0.53-4.80); it exceeded 1 year in 12% of cases, though no particular symptom was associated with exceptionally long or short delays.

CONCLUSIONS:

This is the largest clinical epidemiology study of BT in young people conducted so far. Many signs and symptoms were identified, dominated by headaches and nausea/vomiting. Diagnosis was generally rapid but in 12% diagnostic delay exceeded 1 year with none of the symptoms been associated with a distinctly long time until diagnosis.

KEYWORDS:

Brain tumor; Central nervous system tumor; Clinical characteristic; Diagnosis; Symptom

PMID:
32124185
DOI:
10.1007/s11060-020-03437-4

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