Analysis of Risk Factors and Survival in Pediatric High-Grade Spinal Cord Astrocytoma: A Population-Based Study

Lam, Sandi; Lin, Yimo; Melkonian, Stephanie C.

doi:10.1159/000353135

Cited by 36 publications

(17 citation statements)

References 28 publications

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“…This does not appear to be previously reported with respect to pediatric patients with spinal cord gliomas, possibly due to the lack of power with small patient populations and their lack of diversity. 4,11,18 Our finding may be due to the disparity in access to health care resources between these 2 populations, because insurance status has been reported as a predictor of survival in adults with glioblastoma; however, socioeconomic status alone does not appear to be associated with worse survival. 15,26 As described below, early diagnosis and surgical treatment are crucial for optimal outcomes, and thus health care disparities must be considered when working up patients with these tumors.…”

Section: Discussionmentioning

confidence: 80%

Pediatric spinal cord astrocytomas: a retrospective study of 348 patients from the SEER database

Luksik

Garzón-Muvdi

Yang

et al. 2017

PED

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OBJECTIVEIntramedullary spinal cord tumors comprise 1%–10% of all childhood central nervous system neoplasms, with astrocytomas representing the most common subtype. Due to their rarity and poor prognosis, large population-based studies are needed to assess the epidemiology and survival risk factors associated with these tumors in the hope of improving outcome. The authors undertook this retrospective study to explore factors that may influence survival in pediatric patients with spinal cord astrocytomas.METHODSUtilizing the Surveillance, Epidemiology, and End Results (SEER) database, a prospective cancer registry, the authors retrospectively assessed survival in histologically confirmed, primary spinal cord astrocytomas in patients 21 years of age and younger. Survival was described with Kaplan-Meyer curves, and a multivariate regression analysis was used to assess the association of several variables with survival while controlling for confounding variables.RESULTSThis analysis of 348 cases showed that age (hazard ratio [HR] 1.05, 95% CI 1.01–1.09, p = 0.017), nonwhite race (HR 1.74, 95% CI 1.11–2.74, p = 0.014), high-grade tumor status (HR 14.67, 95% CI 6.69–32.14, p < 0.001), distant or invasive extension of the tumor (HR 2.37, 95% CI 1.02–5.49, p = 0.046), and radiation therapy (HR 3.74, 95% CI 2.18–6.41, p < 0.001) were associated with decreased survival. Partial resection (HR 0.37, 95% CI 0.16–0.83, p = 0.017) and gross-total resection (HR 0.39, 95% CI 0.16–0.95, p = 0.039) were associated with improved survival.CONCLUSIONSYounger age appears to be protective, while high-grade tumors have a much worse prognosis. Early diagnosis and access to surgery appears necessary for improving outcomes, while radiation therapy has an unclear role. There is still much to learn about this disease in the hope of curing children with the misfortune of having one of these rare tumors.

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Section: Discussionmentioning

confidence: 80%

Pediatric spinal cord astrocytomas: a retrospective study of 348 patients from the SEER database

Luksik

Garzón-Muvdi

Yang

et al. 2017

PED

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“…[4,30,31] Another study claimed that there was no significant relationship between RT and survival outcomes. [32] Kaplan–Meier analysis (Fig. 6) showed that postoperative RT has a significant effect on overall survival (log-rank P = 0.007).…”

Section: Discussionmentioning

confidence: 99%

Primary spinal glioblastoma multiforme

Shen

Zhao

et al. 2017

Medicine

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Rationale:Primary spinal glioblastoma multiforme (GBM) is a rare clinical entity with an aggressive course and an invariably dismal prognosis. Its clinical characteristics, radiologic and pathologic findings, and treatment protocols have been discussed in a few cases.Patient concerns:A 15-year-old female was admitted to the neurology department with a chief complaint of progressive numbness and weakness in her left upper extremity for 3 months and neck pain for 1 month.Diagnoses:Spinal magnetic resonance imaging showed an intramedullary expansile mass localized between C4 and C7. The diagnosis of GBM was determined on the basis of the histopathological findings after operation.Interventions:Laminotomy and laminoplasty between C4 and C7 were performed, and the tumor was partially resected. The patient was administered focal adjuvant radiotherapy concomitantly with oral chemotherapy following the surgery.Outcomes:With severe neurologic deficits at 13 months after the diagnosis, the patient expired.Lessons:Although therapeutic options have been improving, the prognosis of the primary spinal GBM remains poor. The treatment of primary spinal GBM entered into a central registry and multiple-center cooperation is important in establishing future therapeutic strategies.

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“…As for radiotherapy, although researchers did not find significant linkage between radiation and prognosis, [33] more people believe radiation can increase survival time in malignant spinal tumor. [25] But the optimal dosage is uncertain, although it is almost always used.…”

Section: Discussionmentioning

confidence: 99%

Glioblastoma multiforme in conus medullaris with intracranial metastasis after postoperative adjuvant therapy

et al. 2017

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Spinal glioblastoma multiforme is not common among spinal cord tumors. According to our literature review, only 27 cases originating from the conus medullaris were reported. We herein reported a case of a 10-year-old child diagnosed with glioblastoma multiforme. The patient received adjuvant radiotherapy and standard temozolomide chemotherapy after total excision. Intracranial lesions were found 1 month after postoperative adjuvant therapy. We described the clinical characteristics and postoperative therapy of the patient, and reviewed all of the published cases of conus medullaris glioblastoma. Location, age, leptomeningeal spread, and secondary hydrocephalus may be predictive factors. Immunohistochemical factors such as p53 and Ki-67 are also important. Combined treatment of surgery and postoperative adjuvant therapy is commonly used, but is controversial.

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Analysis of Risk Factors and Survival in Pediatric High-Grade Spinal Cord Astrocytoma: A Population-Based Study

Cited by 36 publications

References 28 publications

Pediatric spinal cord astrocytomas: a retrospective study of 348 patients from the SEER database

Pediatric spinal cord astrocytomas: a retrospective study of 348 patients from the SEER database

Primary spinal glioblastoma multiforme

Glioblastoma multiforme in conus medullaris with intracranial metastasis after postoperative adjuvant therapy

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