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Analysis of risk factors and survival in pediatric high-grade spinal cord astrocytoma: a population-based study
Sandi Lam1, Yimo Lin, Stephanie Melkonian
1Section of Neurosurgery, Department of Surgery, University of Chicago, Chicago, IL 60637, USA. slam@surgery.bsd.uchicago.edu
Insights
Younger age and lower tumor grade improve survival for pediatric high-grade spinal cord astrocytomas. These rare cancers have poor prognoses, and survival is not linked to sex, race, or treatment type.
Area of Science:
- Pediatric Oncology
- Neuro-Oncology
- Cancer Epidemiology
Background:
- Primary pediatric high-grade spinal cord astrocytomas are rare and aggressive tumors.
- These neoplasms are associated with a poor prognosis in affected children.
- Understanding prognostic factors is crucial for improving outcomes.
Purpose of the Study:
- To analyze prognostic factors influencing survival in pediatric high-grade spinal cord astrocytomas.
- To identify demographic, tumor grade, and treatment-related factors affecting patient outcomes.
- To leverage the Surveillance, Epidemiology, and End Results (SEER) database for comprehensive analysis.
Main Methods:
- Retrospective analysis of pediatric patients diagnosed with primary high-grade spinal cord astrocytoma (WHO grade III-IV).
- Data sourced from the SEER database spanning from 1973 to 2008.
- Univariate and multivariate Cox proportional hazards models employed to assess survival predictors.
Main Results:
- Median survival for the cohort of 48 patients was 10 months.
- Increasing patient age and higher tumor grade (WHO IV vs. III) were significantly associated with increased mortality.
- Younger age groups (<7 years) demonstrated longer median survival (22 months) compared to older groups.
- No statistically significant association found between sex, race, radiation therapy, or extent of surgical resection and mortality.
Conclusions:
- Younger age at diagnosis and lower tumor grade are favorable prognostic indicators for pediatric high-grade spinal cord astrocytomas.
- Demographic factors and common treatment modalities did not show a significant impact on survival.
- Further research may be needed to identify novel therapeutic targets and improve survival rates.
Background/Aims:
Primary pediatric high-grade spinal cord astrocytomas are rare neoplasms with poor prognoses. Using the Surveillance, Epidemiology, and End Results (SEER) database, we analyzed prognostic factors and survival.
Methods:
Pediatric patients with histologically confirmed diagnoses of primary high-grade spinal cord astrocytoma (WHO grade III-IV) from 1973 to 2008 in the SEER database were studied. Univariate and multivariate Cox proportional hazards models were used to analyze the relationship between demographic, tumor grade, and treatment factors on survival.
Results:
Median survival in the 48 patient cohort was 10 months. Increasing age and higher tumor grade were found to be significantly associated with higher mortality. For children aged <7, 7-12, and 13-18 years, median survival was 22, 11, and 8 months, respectively. For children with anaplastic astrocytoma (WHO grade III), median survival was 12 months, compared with 7 months for those with glioblastoma multiforme (WHO grade IV). This study did not find a statistically significant relationship between sex, race, presence of radiation therapy or extent of surgical resection and mortality.
Conclusion:
Survival in primary pediatric high-grade spinal cord astrocytomas was positively associated with younger age and lower tumor grade. Survival was not associated with other demographic or treatment modality factors.
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