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Malignant pineal germ-cell tumors: an analysis of cases from three tumor registries
J Lee Villano1, Jennifer M Propp, Kimberly R Porter
1Department of Epidemiology/Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor Street, Chicago, IL 60612, USA.
Abstract:
The exact incidence of pineal germ-cell tumors is largely unknown. The tumors are rare, and the number of patients with these tumors, as reported in clinical series, has been limited. The goal of this study was to describe pineal germ-cell tumors in a large number of patients, using data from available brain tumor databases. Three different databases were used: Surveillance, Epidemiology, and End Results (SEER) database (1973-2001); Central Brain Tumor Registry of the United States (CBTRUS; 1997-2001); and National Cancer Data Base (NCDB; 1985-2003). Tumors were identified using the International Classification of Diseases for Oncology, third edition (ICD-O-3), site code C75.3, and categorized according to histology codes 9060-9085. Data were analyzed using SAS/STAT release 8.2, SEER*Stat version 5.2, and SPSS version 13.0 software. A total of 1,467 cases of malignant pineal germ-cell tumors were identified: 1,159 from NCDB, 196 from SEER, and 112 from CBTRUS. All three databases showed a male predominance for pineal germ-cell tumors (>90%), and >72% of patients were Caucasian. The peak number of cases occurred in the 10- to 14-year age group in the CBTRUS data and in the 15- to 19-year age group in the SEER and NCDB data, and declined significantly thereafter. The majority of tumors (73%-86%) were germinomas, and patients with germinomas had the highest survival rate (>79% at 5 years). Most patients were treated with surgical resection and radiation therapy or with radiation therapy alone. The number of patients included in this study exceeds that of any study published to date. The proportions of malignant pineal germ-cell tumors and intracranial germ-cell tumors are in range with previous studies. Survival rates for malignant pineal germ-cell tumors are lower than results from recent treatment trials for intracranial germ-cell tumors, and patients that received radiation therapy in the treatment plan either with surgery or alone survived the longest.
Insights
This study analyzed 1,467 malignant pineal germ-cell tumors, finding a male predominance and peak incidence in adolescents. Germinomas were most common, with radiation therapy improving survival rates.
Area of Science:
- Neuro-oncology
- Epidemiology
- Cancer Research
Background:
- Pineal germ-cell tumors are rare, with limited data on their incidence and characteristics.
- Previous studies have been constrained by small patient cohorts.
Purpose of the Study:
- To describe the epidemiology and outcomes of malignant pineal germ-cell tumors using large, multi-database data.
- To identify demographic trends, tumor types, and survival rates in this patient population.
Main Methods:
- Utilized data from three major cancer registries: SEER (1973-2001), CBTRUS (1997-2001), and NCDB (1985-2003).
- Identified tumors using ICD-O-3 site code C75.3 and histology codes 9060-9085.
- Analyzed a total of 1,467 malignant pineal germ-cell tumor cases.
Main Results:
- A significant male predominance (>90%) and Caucasian majority (>72%) were observed.
- Peak incidence occurred in the 10-19 year age range, with germinomas comprising 73%-86% of tumors.
- Five-year survival for germinomas exceeded 79%; radiation therapy, with or without surgery, correlated with the longest survival.
Conclusions:
- This study provides the largest dataset to date on pineal germ-cell tumors, confirming known demographic patterns.
- Survival rates for malignant pineal germ-cell tumors are lower than for other intracranial germ-cell tumors.
- Radiation therapy appears to be a key component in improving survival for these rare tumors.
