Skip to main content

Advertisement

SpringerLink
Log in

Clinical features and outcomes of pediatric intracranial gliomas: results from single center’s 226 cases and corroborated with SEER database

  • Original Article
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Background

Pediatric gliomas are the most common central nervous system (CNS) tumors in children and adolescents and show different clinical and histopathological characteristics from the adult. The prognostic factors were poorly defined in pediatric intracranial gliomas.

Methods

We collected pediatric intracranial glioma cases in our institution between February 2011 and June 2022. The patient clinical data, tumor growth characteristics, treatments, and follow-up data were analyzed by Cox regression analysis to identify impact factors on the prognosis of pediatric intracranial glioma patients. To corroborate our data, an independent cohort of pediatric intracranial glioma from the Surveillance, Epidemiology, and End Results Program (SEER) database was analyzed.

Results

A total of 181 cases of pediatric low-grade glioma (PLGG) and 45 cases of pediatric high-grade glioma (PHGG) were included. In multivariate Cox regression analysis, tumor size > 59.5 mm (p = 0.006) and non-gross total resection (non-GTR; subtotal resection, STR, p = 0.042; biopsy, p = 0.012) were associated with decreased overall survival (OS) in PLGG patients. In PHGG patients, only chemotherapy (p = 0.023) was associated with OS while tumor size was marginally prognostic for OS (p = 0.051). Additional independent analysis of 2734 PLGG and 741 PHGG from the SEER database corroborated that larger tumor size was associated with decreased OS in LGG (p = 0.001) and HGG (p < 0.001) patients, separately.

Conclusion

In this study, we found that tumor size was a significant prognostic factor for the OS of PLGG patients in our series. Besides the tumor size, the extent of resection also independently impacted the prognosis of PLGG patients. While in PHGG patients, only chemotherapy was associated with improved OS and tumor size was marginally prognostic.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

The original contributions presented in the study are presented in the article or Supplementary Material. Upon reasonable request, the corresponding authors will provide further data.

References

  1. Sturm D, Pfister SM, Jones DTW (2017) Pediatric gliomas: current concepts on diagnosis, biology, and clinical management. J Clin Oncol : Official J Am Soc Clin Oncol 35(21):2370–2377

    Article  Google Scholar 

  2. Louis DN, Perry A, Wesseling P, Brat DJ, Cree IA, Figarella-Branger D et al (2021) The 2021 WHO classification of tumors of the central nervous system: a summary. Neuro-oncology

  3. Pfister SM, Reyes-Múgica M, Chan JKC, Hasle H, Lazar AJ, Rossi S et al (2022) A summary of the inaugural WHO classification of pediatric tumors: transitioning from the optical into the molecular era. Cancer Discov 12(2):331–355

    Article  PubMed  Google Scholar 

  4. Varlet P, Le Teuff G, Le Deley MC, Giangaspero F, Haberler C, Jacques TS et al (2020) WHO grade has no prognostic value in the pediatric high-grade glioma included in the HERBY trial. Neuro Oncol 22(1):116–127

    Article  CAS  PubMed  Google Scholar 

  5. Gilles FH, Brown WD, Leviton A, Tavaré CJ, Adelman L, Rorke LB et al (2000) Limitations of the World Health Organization classification of childhood supratentorial astrocytic tumors. Children Brain Tumor Consortium Cancer 88(6):1477–1483

    CAS  PubMed  Google Scholar 

  6. Boudaouara O, Charfi S, Bahri M, Daoud J, Boudawara MZ, Gouiaa N et al (2019) Pediatric high grade gliomas: clinico-pathological profile, therapeutic approaches and factors affecting overall survival. Neurochirurgie 65(2–3):63–68

    Article  CAS  PubMed  Google Scholar 

  7. Wen J, Chen W, Zhu Y, Zhang P (2021) Clinical features associated with the efficacy of chemotherapy in patients with glioblastoma (GBM): a surveillance, epidemiology, and end results (SEER) analysis. BMC Cancer 21(1):81

    Article  PubMed  PubMed Central  Google Scholar 

  8. Alattar AA, Brandel MG, Hirshman BR, Dong X, Carroll KT, Ali MA et al (2018) Oligodendroglioma resection: a Surveillance, Epidemiology, and End Results (SEER) analysis. J Neurosurg 128(4):1076–1083

    Article  PubMed  Google Scholar 

  9. Ai X, Liao X, Li J, Tang P, Jiang J (2020) Clinical outcomes of N3 breast cancer: a real-world study of a single institution and the US Surveillance, Epidemiology, and End Results (SEER) Database. Cancer Manag Res 12:5331–5343

    Article  PubMed  PubMed Central  Google Scholar 

  10. Miller KD, Ostrom OT, Kruchko C, Patil N, Tihan T, Cioffi G et al (2021) Brain and other central nervous system tumor statistics, 2021. CA: Cancer J Clin 71(5):381–406

    PubMed  Google Scholar 

  11. Ostrom QT, Cioffi G, Waite K, Kruchko C, Barnholtz-Sloan JS (2021) CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2014–2018. Neuro-oncology 23(12 Suppl 2):iii1–iii105

    Article  PubMed  PubMed Central  Google Scholar 

  12. Espinoza JC, Haley K, Patel N, Dhall G, Gardner S, Allen J et al (2016) Outcome of young children with high-grade glioma treated with irradiation-avoiding intensive chemotherapy regimens: final report of the Head Start II and III trials. Pediatr Blood Cancer 63(10):1806–1813

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Finlay JL, Boyett JM, Yates AJ, Wisoff JH, Milstein JM, Geyer JR et al (1995) Randomized phase III trial in childhood high-grade astrocytoma comparing vincristine, lomustine, and prednisone with the eight-drugs-in-1-day regimen. Childrens Cancer Group. J Clin Oncol : Official J Am Soc Clin Oncol 13(1):112–123

  14. Wolff JE, Gnekow AK, Kortmann RD, Pietsch T, Urban C, Graf N et al (2002) Preradiation chemotherapy for pediatric patients with high-grade glioma. Cancer 94(1):264–271

    Article  CAS  PubMed  Google Scholar 

  15. Jalali R, Rishi A, Goda JS, Sridhar E, Gurav M, Sharma P et al (2016) Clinical outcome and molecular characterization of pediatric glioblastoma treated with postoperative radiotherapy with concurrent and adjuvant temozolomide: a single institutional study of 66 children. Neuro-oncol Pract 3(1):39–47

    Article  Google Scholar 

  16. Azizi AA, Paur S, Kaider A, Dieckmann K, Peyrl A, Chocholous M et al (2018) Does the interval from tumour surgery to radiotherapy influence survival in paediatric high grade glioma?. Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft [et al] 194(6):552–559

    Article  Google Scholar 

  17. Sposto R, Ertel IJ, Jenkin RD, Boesel CP, Venes JL, Ortega JA et al (1989) The effectiveness of chemotherapy for treatment of high grade astrocytoma in children: results of a randomized trial. A report from the Childrens Cancer Study Group. J Neuro-oncol 7(2):165–77

  18. Jung TY, Lee JY, Kim DS, Park HJ, Kim CY, Ra YS et al (2015) Pediatric supratentorial high-grade glioma: multicenter retrospective observational study of the Korean Society for Pediatric Neuro-Oncology. J Neurooncol 121(2):413–419

    Article  PubMed  Google Scholar 

  19. Napieralska A, Krzywon A, Mizia-Malarz A, Sosna-Zielińska J, Pawłowska E, Krawczyk MA et al (2021) High-grade gliomas in children-a multi-institutional Polish study. Cancers 13(9)

  20. Shaw EG, Wisoff JH (2003) Prospective clinical trials of intracranial low-grade glioma in adults and children. Neuro Oncol 5(3):153–160

    Article  PubMed  PubMed Central  Google Scholar 

  21. Pignatti F, Van den Bent M, Curran D, Debruyne C, Sylvester R, Therasse P et al (2002) Prognostic factors for survival in adult patients with cerebral low-grade glioma. J Clin Oncol : Official J Am Soc Clin Oncol 20(8):2076–2084

    Article  Google Scholar 

  22. Maxwell R, Luksik AS, Garzon-Muvdi T, Yang W, Huang J, Bettegowda C et al (2018) Population-based study determining predictors of cancer-specific mortality and survival in pediatric high-grade brainstem glioma. World neurosurg 119:e1006–e1015

    Article  PubMed  Google Scholar 

  23. Ater JL, Zhou T, Holmes E, Mazewski CM, Booth TN, Freyer DR et al (2012) Randomized study of two chemotherapy regimens for treatment of low-grade glioma in young children: a report from the Children’s Oncology Group. J Clin Oncol : Official J Am Soc Clin Onc 30(21):2641–2647

    Article  Google Scholar 

  24. Bartlett A, Lane A, Chaney B, Escorza NY, Black K, Cochrane A et al (2022) Characteristics of children ≤36 months of age with DIPG: A report from the international DIPG registry. Neuro Oncol 24(12):2190–2199

  25. Erker C, Lane A, Chaney B, Leary S, Minturn JE, Bartels U et al (2022) Characteristics of patients ≥10 years of age with diffuse intrinsic pontine glioma: a report from the International DIPG/DMG Registry. Neuro Oncol 24(1):141–152

    Article  CAS  PubMed  Google Scholar 

  26. Metzger S, Weiser A, Gerber NU, Otth M, Scheinemann K, Krayenbühl N et al (2022) Central nervous system tumors in children under 5 years of age: a report on treatment burden, survival and long-term outcomes. J Neurooncol 157(2):307–317

    Article  PubMed  PubMed Central  Google Scholar 

  27. Hidalgo ET, Kvint S, Orillac C, North E, Dastagirzada Y, Chang JC et al (2019) Long-term clinical and visual outcomes after surgical resection of pediatric pilocytic/pilomyxoid optic pathway gliomas. J Neurosurg Pediatr 24(2):166–173

    Article  PubMed  Google Scholar 

  28. Garzón M, García-Fructuoso G, Suñol M, Mora J, Cruz O (2015) Low-grade gliomas in children: single institutional experience in 198 cases. Child’s Nerv Syst : ChNS : Official J Int Soc Pediatr Neurosurg 31(9):1447–1459

    Article  Google Scholar 

  29. Liu H, Chen Y, Qin X, Jin Z, Jiang Y, Wang Y (2022) Epidemiology and survival of patients with optic pathway gliomas: a population-based analysis. Front Oncol 12:789856

    Article  PubMed  PubMed Central  Google Scholar 

  30. Qaddoumi I, Sultan I, Gajjar A (2009) Outcome and prognostic features in pediatric gliomas: a review of 6212 cases from the Surveillance, Epidemiology, and End Results database. Cancer 115(24):5761–5770

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by the National Natural Science Foundation of China (82072795, Feng Wan). No other specific grant was received for this research from the public, commercial, or not-for-profit funding agencies.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University Science and Technology, Wuhan, 430030, China

    Zirong Chen, Zhongyin Guo, Junhong Wang, Dan Cao, Yu Xu, Fangyong Dong & Feng Wan

  2. Department of Neurosurgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China

    Feng Wan

Authors
  1. Zirong Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhongyin Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Junhong Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dan Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yu Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Fangyong Dong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Feng Wan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conception and design: Feng Wan; acquisition of clinical information and data: Zirong Chen, Zhongyin Guo, Junhong Wang; analysis and interpretation of data: Zirong Chen, Junhong Wang; reviewing, and/or revising the manuscript: Zirong Chen, Dan Cao, Yu Xu, Fangyong Dong, and Feng Wan. The final manuscript was read and approved by all authors.

Corresponding author

Correspondence to Feng Wan.

Ethics declarations

Ethics approval

An Institutional Review Board (IRB) from Tongji Hospital, Tongji Medical School, Huazhong University Science and Technology approved the collection of all clinical information used in this study (TJ-IRB20211271).

Conflict of interest

There are no conflicts of interest and no disclosures on behalf of any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 221 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chen, Z., Guo, Z., Wang, J. et al. Clinical features and outcomes of pediatric intracranial gliomas: results from single center’s 226 cases and corroborated with SEER database. Childs Nerv Syst 39, 593–601 (2023). https://doi.org/10.1007/s00381-023-05841-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-023-05841-3

Keywords

Search

Navigation