Malignant glioma
Characterization and outcomes of infratentorial malignant glioma: A population-based study using the Surveillance Epidemiology and End-Results database

https://doi.org/10.1016/j.radonc.2010.04.007Get rights and content

Abstract

Purpose

Using a population-based database, we sought to characterize brainstem gliomas and to evaluate the prognosis of various subgroups.

Materials and methods

Using the Surveillance Epidemiology and End-Results (SEER) database we identified patients diagnosed with malignant infratentorial gliomas between 1988 and 2003 who underwent a surgical procedure and/or received radiation therapy (RT).

Results

A total of 455 patients were identified with a median age at diagnosis of 13 years (range 0–87). The overwhelming majority, 95.6%, received RT. Median survival (MS) was 11 months. Those not undergoing RT had a MS of 3 months. MS varied significantly by age, p < 0.001. MS for patients aged 0–18 years was 11 months; 19–29 years was 35 months; 30–49 years was 17 months; 50–69 years was 6 months; and 70 years or older was 3 months. The small group with grades I and II tumors had improved MS of 58 and 37 months, respectively. There was no difference in survival by the year of diagnosis (⩽1999 versus 2000 or later) with MS of 10 versus 11 months, respectively, p = 0.949.

Conclusion

Brainstem glioma is primarily a childhood malignancy with a generally poor prognosis. A minority of patients has favorable features and can achieve long-term survival.

Section snippets

Materials and methods

We obtained data for this study through the National Cancer Institute sponsored Surveillance Epidemiology and End-Results (SEER) database, SEER-17 registry, released in November 2007 [12]. The SEER program is a population-based registry capturing de-identified personal data regarding individual cancer diagnoses and outcomes within the registry population. The registry population, as of the SEER-17 release, included a wide range of ethnic and demographic groups across the United States,

Results

A total of 455 patients were identified. The patients ranged in age from 0 to 87 years with a median age of 13 years. The majority of patients, 55.6%, were pediatric age (0–18 years). No significant gender predominance was noted in the cohort. The most common site of disease was confined to brainstem.

As indicated above, all patients identified for this study underwent surgery and/or radiation therapy. Radiation therapy was the most frequently employed treatment modality: 435 of 455 patients

Discussion

Infratentorial malignant glioma is a predominantly pediatric disease with a poor prognosis overall. The historical presentation and prognosis of pediatric brainstem glioma is reflected in our study. This study, however, also offers insight into the presentation of these tumors in adults and, to our knowledge, represents the largest series of adults with infratentorial malignant glioma. Unlike pediatric patients, younger adults tend to have better prognosis associated with lower grade tumors.

Conflict of interest statement

The authors have no relevant or potential conflicts of interest to disclose.

References (21)

There are more references available in the full text version of this article.

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