Worldwide Trends in Survival From Common Childhood Brain Tumors: A Systematic Review

Abstract

PURPOSE The histology of brain tumors determines treatment and predicts outcome. Population-based survival reflects the effectiveness of a health care system in managing cancer. No systematic review of worldwide variation and time trends in survival from brain tumors in children is currently available. PATIENTS AND METHODS We considered longitudinal, observational studies comprising children diagnosed with intracranial astrocytic or embryonal tumors. We searched six electronic databases from database inception to September 30, 2018, using complex search strategies. The outcome measure was 5-year survival, estimated through a time-to-event analysis. This study is registered with PROSPERO, number CRD42018111981. RESULTS Among 5,244 studies, we identified 47 eligible articles that provided 228 survival estimates. Only five studies were entirely or partially conducted in low-income or middle-income countries. Five-year survival from embryonal tumors increased from 37% in 1980 to approximately 60% in 2009. Although survival for medulloblastoma improved substantially (from 29% to 73% during 1959-2009), survival for primitive neuroectodermal tumors wavered over time (1973-2009) and between countries. Five-year survival from astrocytoma changed very little over the 27 years between 1982 and 2009 (from 78% to 89%). Interpretation of the literature was made difficult by the heterogeneity of study designs. CONCLUSION Survival has improved for embryonal tumors, but little change has been observed for astrocytic tumors. We found a striking gap in knowledge about survival from childhood brain tumor subtypes in middle-income and low-income countries, where half of these tumors are diagnosed. Larger studies are needed, including in under-represented countries and based on standardized data collection, to provide up-to-date survival estimates.

Global Trends in Survival From Astrocytic Tumors in Adolescents and Young Adults: A Systematic Review

“…We found that 5-year survival from astrocytoma in adolescents and young adults mostly varied between 48.0% and 71.0% during 1973-2004. Conversely, in children (0-14 years), survival from astrocytoma varied between 71.0% and 89.0% in most countries during 1970-2009 ( 37 ). Differences in survival between the 2 age groups, however, were less remarkable when more granular morphology definitions, instead of ICCC, were used, but studies adopting such strategy were scarce ( 37 ).…”

“…Conversely, in children (0-14 years), survival from astrocytoma varied between 71.0% and 89.0% in most countries during 1970-2009 ( 37 ). Differences in survival between the 2 age groups, however, were less remarkable when more granular morphology definitions, instead of ICCC, were used, but studies adopting such strategy were scarce ( 37 ). Such discrepancy emphasizes the limitations of ICCC in accounting for the substantial differences in the morphology distribution of astrocytic tumors between children, and adolescents and young adults.…”

Sequential improvement in paediatric medulloblastoma outcomes in a low-and-middle-income country setting over three decades

“…They constitute the leading cause of paediatric cancerassociated deaths worldwide, despite lower incidence rates in comparison with haematological malignancies. 1 http://www.sajo.org.za Open Access tumours exhibited the lowest survival rate with a median survival time of 18 months compared with 47 months for leukaemia cases. 1,2 Medulloblastoma (MB) is the most common malignant paediatric brain tumour, comprising a group of histologically and molecularly diverse posterior fossa tumours, pathologically described as undifferentiated, small round blue cells with mild-to-moderate nuclear pleomorphism and high mitotic counts.…”

“…1 http://www.sajo.org.za Open Access tumours exhibited the lowest survival rate with a median survival time of 18 months compared with 47 months for leukaemia cases. 1,2 Medulloblastoma (MB) is the most common malignant paediatric brain tumour, comprising a group of histologically and molecularly diverse posterior fossa tumours, pathologically described as undifferentiated, small round blue cells with mild-to-moderate nuclear pleomorphism and high mitotic counts. These tumours are of embryonic origin and are believed to have originated from progenitor cell lineages present during early brain development.…”

Myalgia and Hematuria in Association with Clonidine and Arginine Administration for Growth Hormone Stimulation Tests

“…One of the patient groups that are commonly tested includes survivors of childhood brain tumors. is is an emerging group of patients, thanks to advances in cancer care and treatments [1][2][3]. However, these children are at risk of GHD due to treatments that include surgery and cranial irradiation of >18 gray and with tumors located in the hypothalamicpituitary region [4,5].…”