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Pediatric versus adult meningioma: comparison of epidemiology, treatments, and outcomes using the Surveillance, Epidemiology, and End Results database

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Abstract

Pediatric meningiomas, which account for < 1% of all meningiomas, are thought to have unique features, including being more aggressive than their adult counterparts. The goal of this investigation was to compare pediatric and adult meningiomas in a large head-to-head comparison. We used the Surveillance, Epidemiology, and End Result (SEER) datasets to compare meningioma demographics, first treatments, and outcomes among children/adolescents (0–21 years), young adults (22–45 years), and older adults (> 45 years). During 2004–2012, SEER contained 59148 patients age 0–107 years diagnosed with meningioma, with children/adolescents accounting for 381 (0.64%) patients. Unlike older and young adults, children/adolescents with meningioma did not demonstrate female predominance, and had an equal 1:1 male-to-female ratio. Children/adolescents also had almost three-times as many spinal tumors (13.1%) than young adults (4.2%) and older adults (4.4%). Both children/adolescents and young adults had undergone more gross total resections (both 43%) versus older adults (25%), and were treated more with radiation (14.6%, and 12.0% respectively) than their older counterparts (8.5%). In addition, both children/adolescents and young adults had significantly lower all-cause mortality (4.5% in both) than older adults (24.6%), during median 35-month follow-up. Inherent limitations of the SEER datasets restrict our ability to answer important questions regarding comparisons of tumor grading, histological diagnosis, cause-specific mortality, and neurofibromatosis status. Pediatric meningiomas appear distinct from their adult counterparts as they do not display the typical female predominance and include more clinically relevant spinal tumors. More extensive surgeries, greater use of radiation therapy, and lower all-cause mortality were seen in both children/adolescents and young adults, which raises questions regarding the perceived uniquely aggressive nature of pediatric meningiomas. However, due to the significant limitations of the SEER datasets, our results must be interpreted cautiously and stand only to foster novel questions, which would be better answered in well-designed, prospective studies.

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Acknowledgements

The authors would like to thank Judith Gault, PhD for her guidance and editorial assistance.

Funding

Morgan Adams Foundation (TCH); The Hartford Foundation for Public Giving (TCH); Colorado Clinical and Translational Sciences Institute/Children’s Hospital Colorado Research Institute KL2 Research Scholar Award NCATS/NIH UL1 TR001082 (TCH); NCI R03 CA212800-01 (TCH).

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Authors and Affiliations

  1. Division of Neurosurgery, Department of Pediatric Surgery, Montreal Children’s Hospital, 1001 Decarie Boulevard, Montreal, QC, H4A-3J1, Canada

    Roy W. R. Dudley & Benjamin Béland

  2. Adult and Children’s Center for Outcomes Research and Delivery, University of Colorado Anschutz Medical Campus, 13199 E. Montview Blvd, Suite 300, Aurora, CO, 80045, USA

    Michelle R. Torok

  3. Pediatric Neurosurgery, Children’s Hospital Colorado, University of Colorado Anschutz Medical Campus, 13123 E. 16th Ave, Box 330, Aurora, CO, 80045, USA

    Sarah Randall, Michael H. Handler & Todd C. Hankinson

  4. Division of Neuro-Oncology, Department of Pediatrics, Children’s Hospital Colorado, University of Colorado Anschutz Medical Campus, 13123 E. 16th Ave, Box 115, Aurora, CO, 80045, USA

    Jean M. Mulcahy-Levy

  5. Department of Radiation Oncology, University of Colorado Anschutz Medical Campus, Anschutz Cancer Pavilion, 1665 Aurora Court, Suite 1032, Aurora, CO, 80045, USA

    Arthur K. Liu

  6. Morgan Adams Foundation Pediatric Brain Tumor Research Program, Aurora, USA

    Jean M. Mulcahy-Levy & Todd C. Hankinson

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  1. Roy W. R. Dudley
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Correspondence to Roy W. R. Dudley.

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Dudley, R.W.R., Torok, M.R., Randall, S. et al. Pediatric versus adult meningioma: comparison of epidemiology, treatments, and outcomes using the Surveillance, Epidemiology, and End Results database. J Neurooncol 137, 621–629 (2018). https://doi.org/10.1007/s11060-018-2756-1

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