The role of sex genotype in paediatric CNS tumour incidence and survival

Abstract

Purpose Evidence exists, in CNS germinomas and medulloblastomas (MB), that patient sex significantly influences incidence and outcome. The role of sex genotype in other paediatric CNS tumours remains unclear. This study sought to examine the role of sex genotype in CNS tumour incidence and overall survival (OS). Methods Age-adjusted incidence and OS rates were collected from the Surveillance Epidemiology and End Result (SEER) registry between 2000 and 2011 for common paediatric (<=19 years) CNS tumours: pilocytic astrocytoma (PA), anaplastic astrocytoma, glioblastoma (GBM), medulloblastoma, supratentorial CNS embryonal tumour, ependymoma, and germinoma. All patients with histologically confirmed, ICD-03 coded, first tumours, were included. Kaplan-Meier and Cox regression analyses were used to calculate hazard ratios (HR). Results The total cases are as follows: males=3018 and females=2276. Highest incidence was seen in PA (n=2103). GBM displayed the worst OS, whilst PA displayed the best. Higher incidence was observed in males for all tumours, except PA. Females with ependymoma had significantly better OS compared to males, whereas males with germinomas had better OS compared to females. Females <1 year with AA had better OS than males. Increasing age significantly improved male and female survival in ependymoma and medulloblastoma. Conclusion Interrogating population-based registries such as SEER minimises bias and provides credible data. Observed differences in incidence and OS between the sexes for different paediatric CNS tumours provide useful prognostic information for clinicians. Sex genotype was a significant independent prognostic factor in ependymomas and germinomas. Further investigation of possible epigenetic and hormonal differences may provide sex-specific vulnerabilities that may be exploitable for targeted therapy.

Prognostic Factors and Histopathological Features of Pediatric Intracranial Ependymomas: Nationwide Brain Tumor Registry-based Study of Japan

“… 3 - 6 ) Males tended to have a longer OS compared with female patients, unlike a previous study. 13 ) On the other hand, traditional histopathological grading was not a prognostic factor in this cohort.…”

“…In supratentorial ependymomas, both L1CAM and NF-kB p65 could be useful surrogate diagnostic markers for ZFTA fusion-positive ependymoma. 13 ) H3K27-trimethylation immunostaining can also be used to distinguish between group A posterior fossa ependymoma and group B posterior fossa ependymoma. 16 ) More practical and accurate diagnostic markers are required for the routine diagnostics of pediatric ependymomas.…”

Machine Learning Model to Identify Prognostic Factors in Glioblastoma: A SEER-Based Analysis

“…Many studies [19][20][21][22][23][24][25][26][27][28] investigate prognosis and survival in GBs using the SEER database. The main difference of our study is that it processes data created following the last two World Health Organisation (WHO) classifications and creates a high-performance model that predicts 1-and 2-year survival using ML.…”

Microglia in pediatric brain tumors: The missing link to successful immunotherapy

“…Importantly, this effect was observed exclusively in male animals and not in females. Given the disparities in brain tumor occurrence between males and females, 126 taking these distinctions into account when evaluating the impact on the immune response in both preclinical and clinical studies could offer valuable insights.…”