The Role of Time as a Prognostic Factor in Pediatric Brain Tumors: a Multivariate Survival Analysis

Barragán-Pérez, Eduardo; Altamirano-Vergara, Carlos Enrique; Alvarez-Amado, Daniel Eduardo; García-Beristain, Juan Carlos; Chico-Ponce-de-León, Fernando; González-Carranza, Vicente; Juárez-Villegas, Luis Enrique; Murata, Chiharu

doi:10.1007/s12253-020-00875-3

Cited by 14 publications

(10 citation statements)

References 41 publications

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“…Sixteen studies met the inclusion criteria, and data were extracted from them (Fig 1). [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] The included studies captured data from 16 LMICs: one low-income country, five lower-middleincome countries, and 10 upper-middle-income countries (Fig 2). Two studies were included from each of Brazil, Mexico, and Turkey.…”

Section: Search Resultsmentioning

confidence: 99%

Outcomes of Children With Low-Grade Gliomas in Low- and Middle-Income Countries: A Systematic Review

Ward

Jones

Witt

et al. 2022

JCO Global Oncology

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PURPOSE Pediatric CNS tumors are increasingly a priority, particularly with the WHO designation of low-grade glioma (LGG) as one of six index childhood cancers. There are currently limited data on outcomes of pediatric patients with LGGs in low- and middle-income countries (LMICs). METHODS To better understand the outcomes of LGGs in LMICs, this systematic review interrogated nine literature databases. RESULTS The search identified 14,977 publications. Sixteen studies from 19 countries met the selection criteria and were included for data abstraction and analysis. Eleven studies (69%) were retrospective reviews from single institutions, and one (6%) captured institutional data prospectively. The studies captured a total of 957 patients with a median of 49 patients per study. Seven (44%) of the studies described the treatment modalities used. Of 373 patients for whom there was information, 173 (46%) had a gross total or near total resection, 109 (29%) had a subtotal resection, and 91 (24%) had only a biopsy performed. Seven studies, with a total of 476 patients, described the frequency of use of radiotherapy and/or chemotherapy in the cohorts: 83 of these patients received radiotherapy and 76 received chemotherapy. The 5-year overall survival ranged from 69.2% to 93.5%, although lower survival rates were reported at earlier time points. We identified limitations in the published studies with respect to the cohort sizes and methodologies. CONCLUSION The included studies reported survival rates frequently exceeding 80%, although the ultimate number of studies was limited, pointing to the paucity of studies describing the outcomes of children with LGGs in LMICs. This study underscores the need for more robust data on outcomes in pediatric LGG.

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Section: Search Resultsmentioning

confidence: 99%

Outcomes of Children With Low-Grade Gliomas in Low- and Middle-Income Countries: A Systematic Review

Ward

Jones

Witt

et al. 2022

JCO Global Oncology

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“…Lack of suspicion is frequent too 30–34 . Nevertheless, the time from symptoms to diagnosis in low‐grade gliomas does not correlate with survival; in fact, it is indicative of a longer survival, which can be observed in this cohort 35,36 …”

Section: Discussionmentioning

confidence: 75%

“…[30][31][32][33][34] Nevertheless, the time from symptoms to diagnosis in low-grade gliomas does not correlate with survival; in fact, it is indicative of a longer survival, which can be observed in this cohort. 35,36 Although the conventional use of MRI over CT scan has become the standard method of diagnosis, many health institutions have not made further use of spectroscopy or other new techniques due to availability, as some patients who are not in a stable condition may have to travel to undergo these tests. 37 Initial diagnosis with CT is common, and once the patient arrives at a third-level center, an MRI is performed.…”

Section: Discussionmentioning

confidence: 99%

Diffuse intrinsic pontine gliomas: First registry effort in Mexico

Robles‐Castro,

Niembro‐Zúñiga,

Ortiz‐Azpilcueta

et al. 2023

Pediatric Blood & Cancer

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Introduction Brainstem tumors comprise 10.9% of all brain tumors, and pediatric diffuse intrinsic pontine gliomas (DIPG) have a fatal prognosis. Some countries have developed national and international register databases to characterize their populations to aid clinical and public policy decisions. This study provides information regarding the clinical characteristics of a retrospective cohort of children with DIPG in México from 2001 to 2021, and assesses the proposed prognostic factors previously described for survival outcome. Methods Health institutions from Mexico were invited to contribute to a retrospective electronic registry of patients with DIPG based on the International DIPG Registry. Fisher's exact test was used to compare long‐ and short‐term survivors. Overall survival was estimated using the Kaplan–Meier method. Differences between survival curves were evaluated using the log‐rank test and Cox proportional hazard regression analysis. Results Total 110 patients were included. The median age of the patients at diagnosis was 7 years. Sixty patients (54.5%) presented with symptoms in less than 6 months; the most frequent symptom was ataxia (56.4%). Ninety patients received treatment (81.8%), the overall survival at 4 years was 11.4%, and 16 patients (14.5%) were admitted for palliative end‐of‐life care. We found no significant survival differences for any of the prognostic factors. Conclusion This study highlights the need to develop strategies to standardize healthcare processes and enhance the quality of care to improve clinical diagnosis in Mexico. We also observed a barrier to the acceptance of palliative end‐of‐life care in the family and medical teams.

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“…Failure to diagnose a child with a central nervous system (CNS) tumor in the emergency department (ED) is a missed opportunity for earlier intervention 1 . Early treatment may decrease morbidity for pediatric CNS tumors, which account for the highest burden of disease-related deaths among children in the United States 1–4 . Recurrent ED visits before diagnosis create additional financial and emotional burdens for families 5 .…”

Section: Introductionmentioning

confidence: 99%

“…Recurrent ED visits before diagnosis create additional financial and emotional burdens for families 5 . Despite this, delayed diagnosis frequently occurs 4,6–11 …”

Section: Introductionmentioning

confidence: 99%

Predictors of Delayed Diagnosis of Pediatric CNS Tumors in the Emergency Department

et al. 2023

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Objective: Central nervous system (CNS) tumor diagnoses are frequently delayed in children, which may lead to adverse outcomes and undue burdens on families. Examination of factors associated with delayed emergency department (ED) diagnosis could identify approaches to reduce delays. Study Design:We performed a case-control study using data from 2014 to 2017 for 6 states. We included children aged 6 months to 17 years with a first diagnosis of CNS tumor in the ED. Cases had a delayed diagnosis, defined as 1 or more ED visits in the 140 days preceding tumor diagnosis (the mean prediagnostic symptomatic interval for pediatric CNS tumors in the United States). Controls had no such preceding visit. Results:We included 2828 children (2139 controls, 76%; 689 cases, 24%). Among cases, 68% had 1 preceding ED visit, 21% had 2, and 11% had 3 or more. Significant predictors of delayed diagnosis included presence of a complex chronic condition (adjusted odds ratio [aOR],

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The Role of Time as a Prognostic Factor in Pediatric Brain Tumors: a Multivariate Survival Analysis

Cited by 14 publications

References 41 publications

Outcomes of Children With Low-Grade Gliomas in Low- and Middle-Income Countries: A Systematic Review

Outcomes of Children With Low-Grade Gliomas in Low- and Middle-Income Countries: A Systematic Review

Diffuse intrinsic pontine gliomas: First registry effort in Mexico

Predictors of Delayed Diagnosis of Pediatric CNS Tumors in the Emergency Department

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