National cancer database analysis of outcomes in pediatric glioblastoma

Liu, Meng; Thakkar, Jigisha P.; García, Cézar; Dolecek, Therese A.; Wagner, Lars M.; Dressler, Emily V.; Villanó, John L.

doi:10.1002/cam4.1404

Cited by 33 publications

(38 citation statements)

References 42 publications

(70 reference statements)

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“…Co-deletion was defined as having both chromosomal arm deletions as reported in the Collaborative Stage Site-Specific Factors by NCDB, cases negative for both chromosome deletions were defined as negative, and patients with only one deletion reported were considered incomplete. Treatment received was assessed as first course of treatment at any CoC facility, as previously described by our group[ 18 ].…”

Section: Methodsmentioning

confidence: 99%

“…Age groups cutoff were determined based on historical reports[ 10 , 11 ] and increased mortality cutoffs using area under the curve. Survival and risk of mortality was assessed as previously described by our group using Kaplan Meier and Cox proportional hazards models[ 18 ]. The level of statistical significance was set at 0.05 for all tests conducted, and all analyses were performed with SAS software version 9.4 (SAS Statistical Institute, Cary, North Carolina).…”

Section: Methodsmentioning

confidence: 99%

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Comprehensive evaluation of treatment and outcomes of low-grade diffuse gliomas

et al. 2018

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BackgroundLow-grade gliomas affect younger adults and carry a favorable prognosis. They include a variety of biological features affecting clinical behavior and treatment. Having no guidelines on treatment established, we aim to describe clinical and treatment patterns of low-grade gliomas across the largest cancer database in the United States.MethodsWe analyzed the National Cancer Database from 2004 to 2015, for adult patients with a diagnosis of World Health Organization grade II diffuse glioma.ResultsWe analyzed 13,621 cases with median age of 41 years. Over 56% were male, 88.4% were white, 6.1% were black, and 7.6% Hispanic. The most common primary site location was the cerebrum (79.9%). Overall, 72.2% received surgery, 36.0% radiation, and 27.3% chemotherapy. Treatment combinations included surgery only (41.5%), chemotherapy + surgery (6.6%), chemotherapy only (3.1%), radiation + chemotherapy + surgery (10.7%), radiation + surgery (11.5%), radiation only (6.1%), and radiotherapy + chemotherapy (6.7%). Radiation was more common in treatment of elderly patients, 1p/19q co-deletion (37.3% versus 24.3%, p<0.01), and tumors with midline location. Median survival was 11 years with younger age, 1p/19q co-deletion, and cerebrum location offered survival advantage.ConclusionsTumor location, 1p/19q co-deletion, and age were the main determinants of treatment received and survival, likely reflecting tumor biology differences. Any form of treatment was preferred over watchful waiting in the majority of the patients (86.1% versus 8.1%). Survival of low-grade gliomas is higher than previously reported in the majority of clinical trials and population-based analyses. Our analysis provides a real world estimation of treatment decisions, use of molecular data, and outcomes.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Comprehensive evaluation of treatment and outcomes of low-grade diffuse gliomas

et al. 2018

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“…Although differences in survival by race and ethnicity are described in pediatric populations with cancers other than brain and CNS cancer and among adults with brain and CNS cancer, differences are less well described for pediatric brain and CNS cancer . Past reports of pediatric brain and CNS cancer and race and ethnicity have documented differences in survival by race and ethnicity for specific histology types or in specific US states . National reports of pediatric brain and CNS cancer have documented worse outcomes among black patients compared to white patients, but have used <28% population coverage and older data, and some did not assess Hispanic ethnicity .…”

Section: Introductionmentioning

confidence: 99%

Racial and ethnic differences in survival of pediatric patients with brain and central nervous system cancer in the United States

Siegel

Ding³

et al. 2018

Pediatric Blood & Cancer

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Background Brain and central nervous system (CNS) cancer is the leading cause of cancer death among children and adolescents in the United States. Data from earlier studies suggested racial and ethnic differences in survival among pediatric patients with brain tumor. This study examined racial/ethnic difference in survival using national data and considered the effects of demographic and clinical factors. Methods Using National Program of Cancer Registries data, 1‐, 3‐, and 5‐year relative survival (cancer survival in the absence of other causes of death) was calculated for patients with brain and CNS cancer aged < 20 years diagnosed during 2001–2008 and followed up through 2013. Racial and ethnic differences in survival were measured by sex, age, economic status, stage, anatomic location, and histology. Adjusted racial and ethnic difference in 5‐year cancer specific survival was estimated using multivariable Cox regression analysis. Results Using data from 11 302 patients, 5‐year relative survival was 77.6% for non‐Hispanic white patients, 69.8% for non‐Hispanic black patients, and 72.9% for Hispanic patients. Differences in relative survival by race/ethnicity existed within all demographic groups. Based on multivariable analysis, non‐Hispanic black patients had a higher risk of death at 5 years after diagnosis compared to non‐Hispanic white patients (adjusted hazard ratio = 1.2, 95% confidence interval, 1.1–1.4). Conclusions Pediatric brain and CNS cancer survival differed by race/ethnicity, with non‐Hispanic black patients having a higher risk of death than non‐Hispanic white patients. Future investigation of access to care, social and economic barriers, and host genetic factors might identify reasons for disparities in survival.

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“…[1][2][3][4] Brain and central nervous system (CNS) tumors are the most common type of pediatric cancer in the United States after leukemia, and have the highest mortality rates among all cancers affecting children. [5][6][7][8][9][10] While the incidence and mortality of pediatric brain and CNS tumors remain high, previous research has identified significant differences across racial and ethnic groups in both diagnosis and treatment in this population. 6,11,12 Several studies have identified a significantly higher incidence of brain and CNS tumors in non-Hispanic White children relative to those in racial/ethnic minorites.…”

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confidence: 99%

“…6,11,12 Several studies have identified a significantly higher incidence of brain and CNS tumors in non-Hispanic White children relative to those in racial/ethnic minorites. [7][8][9]13 While scientific breakthroughs in cancer treatment have improved cancer survival, leading to a one-third decrease in overall pediatric cancer mortality from 1990 to 2016, these advances have not benefited all racial/ethnic groups equally. 1,14 Specifically, despite the observed improvement in overall survival for pediatric cancers, disparities are evident in access to and use of guideline-recommended treatment and outcomes across racial/ethnic groups.…”

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Racial and ethnic disparities in survival of children with brain and central nervous tumors in the United States

Haizel-Cobbina

Spector

Moertel

et al. 2020

Pediatric Blood & Cancer

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Background: Despite improvements in overall survival for pediatric cancers, treatment disparities remain for racial/ethnic minorities compared to non-Hispanic Whites; however, the impact of race on treatment outcomes for pediatric brain and central nervous system (CNS) tumors in the United States is not well known. Methods: We included 8713 children aged 0-19 years with newly diagnosed primary brain and CNS tumors between 2000 and 2015 from the Census Tract-level SES and Rurality Database developed by Surveillance, Epidemiology, and End Results (SEER) Program. We used chi-square tests to assess differences in sociodemographic, cancer, and treatment characteristics by race/ethnicity and Kaplan-Meier curves and Cox proportional hazards models to examine differences in 10-year survival, adjusting for these characteristics. Results: Among 8713 patients, 56.75% were non-Hispanic White, 9.59% non-Hispanic Black, 25.46% Hispanic, and 8.19% from "other" racial/ethnic groups. Median unadjusted survival for all pediatric brain tumors was 53 months, but varied significantly by race/ethnicity with a median survival of 62 months for non-Hispanic Whites, 41 months for non-Hispanic Blacks, and 40 months for Hispanic and other. Multivariable analyses demonstrated minority racial groups still had significantly higher hazard of death than non-Hispanic Whites; Hispanic (adjusted hazard ratio [aHR] 1.25 [1.18-1.31]); non-Hispanic Black (aHR 1.12 [1.04-1.21]); other (aHR 1.22 [1.12-1.32]). Results were consistent when stratified by tumor histology. Conclusion: We identified disparities in survival among racial/ethnic minorities with pediatric brain and CNS tumors, with Hispanic patients having the highest risk of mortality. Eliminating these disparities requires commitment toward promoting heath equity and personalized cancer treatment.

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National cancer database analysis of outcomes in pediatric glioblastoma

Cited by 33 publications

References 42 publications

Comprehensive evaluation of treatment and outcomes of low-grade diffuse gliomas

Comprehensive evaluation of treatment and outcomes of low-grade diffuse gliomas

Racial and ethnic differences in survival of pediatric patients with brain and central nervous system cancer in the United States

Racial and ethnic disparities in survival of children with brain and central nervous tumors in the United States

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