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Prognosis of Pineal Region Tumors in Children: A Population-Based Study
Fengqiang Shen1, Nan Shen2, Chen Wang3
1Department of Pediatrics, The First Affiliated Hospital of Huzhou Normal University, the First People's Hospital of Huzhou, Huzhou, China.
Insights
Pediatric pineal region tumors (PRTs) survival is impacted by age and tumor type. Younger children and those with pineoblastomas face worse outcomes, while radiation therapy improves survival rates for PRTs.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Cancer Epidemiology
Background:
- Pineal region tumors (PRTs) are rare in children, necessitating research into their prognostic factors and survival.
- Understanding survival outcomes is crucial for developing effective treatment strategies for pediatric PRTs.
Purpose of the Study:
- To evaluate prognostic factors influencing survival in pediatric patients diagnosed with malignant pineal region tumors.
- To analyze survival outcomes using a large population-based registry.
Main Methods:
- Retrospective cohort study using Surveillance, Epidemiology, and End Results (SEER) data (2000-2019).
- Inclusion of pediatric patients (0-18 years) with histologically verified malignant PRTs.
- Survival analyses performed using Kaplan-Meier and Cox proportional hazards models; a predictive nomogram was developed.
Main Results:
- A cohort of 596 pediatric patients with PRTs was analyzed.
- Germ cell tumors (63.3%) were most common, followed by pineoblastomas (26.3%); overall 5-year survival was 79.6%.
- Significant predictors of survival included age at diagnosis, SEER stage, histology, and radiation therapy; younger age and pineoblastomas correlated with poorer outcomes.
Conclusions:
- Early age at diagnosis and aggressive histologies like pineoblastomas are linked to worse survival in pediatric PRTs.
- Radiation therapy demonstrates a positive association with improved survival.
- Future research should integrate histological and molecular profiles to refine therapeutic protocols for pediatric PRTs.
Background:
This study aims to evaluate the prognostic factors and survival outcomes of pediatric patients with pineal region tumors (PRTs) using a large population-based registry.
Methods:
We employed a retrospective cohort design, utilizing data from the Surveillance, Epidemiology, and End Results program, covering the period from 2000 to 2019. We included pediatric patients (ages 0-18) with histologically verified malignant PRTs. To determine prognostic indicators, we conducted survival analyses using Kaplan-Meier methods and Cox proportional hazards models. Furthermore, we constructed a predictive nomogram derived from the Cox regression outcomes.
Results:
The study included 596 pediatric patients with PRTs. Germ cell tumors were the most common subtype (63.3%), followed by pineoblastomas (26.3%) and other subtypes (10.4%). The overall 5-year survival rate was 79.6%. Multivariate analysis revealed that age at diagnosis, Surveillance, Epidemiology, and End Results stage, histological subtypes, and radiation therapy were significant predictors of survival. Patients under 5 years of age and those diagnosed with pineoblastomas had worse survival outcomes. Radiation therapy was associated with improved survival.
Conclusions:
Early age at diagnosis and aggressive histological types such as pineoblastomas are associated with poorer outcomes. Future research should focus on refining therapeutic protocols that integrate the histological and molecular profiles of these tumors.
