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Gliomas of the Optic Nerve: A SEER-Based Epidemiologic Study
Fatma Dihowm1, Luis A Alvarado, Curtis E Margo
1Department of Internal Medicine (FD), Paul L. Foster School of Medicine, Tech University Health Sciences Center Texas, El Paso, Texas; Biostatistics and Epidemiological Consulting Lab (LAA), Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, Texas; and Department of Pathology and Cell Biology, and Ophthalmology (CEM), Morsani College of Medicine, University of South Florida, Tampa, Florida.
Biopsy-confirmed optic nerve gliomas show worse outcomes than radiologically diagnosed cases. This highlights the need for accurate diagnostic coding in cancer registries for better patient outcome interpretation.
Area of Science:
- Neuro-oncology
- Ophthalmology
- Cancer Epidemiology
Background:
- Optic nerve gliomas can be diagnosed via biopsy or imaging.
- Clinical features and outcomes may differ based on diagnostic method.
Purpose of the Study:
- To compare clinical features and outcomes of optic nerve gliomas diagnosed by biopsy versus imaging alone.
Main Methods:
- Retrospective analysis of 1033 pilocytic astrocytomas (PAs) and optic nerve gliomas from the SEER registry (1975-2017).
- Comparison of demographics, clinical features, and outcomes based on diagnostic method (biopsy vs. imaging) and age.
- Statistical analysis using chi-square tests and logistic regression (α < 0.01).
Main Results:
- Biopsy was more frequent for PAs (54%) than gliomas (13.2%).
- Biopsied PAs and gliomas had higher tumor-attributable death rates (7.1% and 7.4%) compared to non-biopsied cases (0.7% and 1.1%).
- Approximately 15% of both tumor types were diagnosed in individuals aged 20 years and older.
Conclusions:
- Biopsy-confirmed optic nerve gliomas and PAs are linked to more interventions and poorer outcomes than radiologically diagnosed cases.
- Limitations in registry data (SEER) hinder meaningful outcome interpretation.
- Cancer registries should avoid coding histopathologic diagnoses without tissue confirmation.
