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Incidence, time trends and survival patterns of childhood pilocytic astrocytomas in Southern-Eastern Europe and SEER, US

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Abstract

Pilocytic astrocytomas (PA) comprise the most common childhood central nervous system (CNS) tumor. Exploiting registry-based data from Southern and Eastern Europe (SEE) and SEER, US, we opted to examine incidence, time trends, survival and tentative outcome disparities of childhood PA by sociodemographic and clinical features. Childhood PA were retrieved from 12 SEE registries (N = 552; 1983–2014) and SEER (N = 2723; 1973–2012). Age-standardized incidence rates (ASR) were estimated and survival was examined via Kaplan–Meier and Cox regression analysis. ASR of childhood PA during 1990–2012 in SEE was 4.2/106, doubling in the USA (8.2/106). Increasing trends, more prominent during earlier registration years, were recorded in both areas (SEE: +4.1 %, USA: +4.6 %, annually). Cerebellum comprised the most common location, apart from infants in whom supratentorial locations prevailed. Age at diagnosis was 1 year earlier in SEE, whereas 10-year survival was 87 % in SEE and 96 % in SEER, improving over time. Significant outcome predictors were age <1 year at diagnosis diagnosis (hazard ratio, HR [95% confidence intervals]: 3.96, [2.28–6.90]), female gender (HR: 1.38, [1.01–1.88]), residence in SEE (HR: 4.07, [2.95–5.61]) and rural areas (HR: 2.23, [1.53–3.27]), whereas non-cerebellar locations were associated with a 9- to 12-fold increase in risk of death. The first comprehensive overview of childhood PA epidemiology showed survival gains but also outcome discrepancies by geographical region and urbanization pointing to healthcare inequalities. The worse prognosis of infants and, possibly, females merits further consideration, as it might point to treatment adjustment needs, whereas expansion of systematic registration will allow interpretation of incidence variations.

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Acknowledgments

We would like to acknowledge the individual Southern Eastern European cancer registries personnel for their dedication in running the registry process; the kind responsiveness and assistance of SEER officials in providing access to USA data; and Nick Dessypris from NARECHEM for his valuable contribution in data quality control and statistical analysis along with Dr Achilles Chatziioannou, Katerina Manolitsi, Mathilda Papathanasiou, Antonios Vakis, Nikolaos Kelekis and Panos Prassopoulos, who have assisted in the compilation and localization of the NARECHEM-BT data.

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Authors and Affiliations

  1. Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Mikras Asias 75, 11527, Athens, Greece

    Marios K. Georgakis, Maria A. Karalexi, Eleni I. Kalogirou, Evdoxia Bouka & Eleni Th. Petridou

  2. National Cancer Registry of Ukraine, National Institute of Cancer, Lomonosova str 33/43, Kyiv, 03022, Ukraine

    Anton Ryzhov

  3. Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Childhood Cancer Subregistry of Belarus, Lesnoe-2, 223040, Minsk, Belarus

    Anna Zborovskaya

  4. Bulgarian National Cancer Registry, National Oncology Hospital, 6 Plovdivsko Pole Street, 1756, Sofia, Bulgaria

    Nadya Dimitrova

  5. Izmir Cancer Registry, Izmir Hub, Izmir & Hacettepe University Institute of Public Health, Zubeyde Hanim Caddesi No: 100, Karsiyaka, 35067, Izmir, Turkey

    Sultan Eser

  6. North Region Cancer Registry of Portugal (RORENO), Portuguese Oncology Institute of Porto, Rua António Bernardino da Almeida, 4200-072, Porto, Portugal

    Luis Antunes

  7. Croatian National Cancer Registry, Croatian Institute of Public Health, Rockefellerova 7, 10000, Zagreb, Croatia

    Mario Sekerija

  8. Cancer Registry of Republic of Slovenia, Institute of Oncology, Zaloška cesta 2, 1000, Ljubljana, Slovenia

    Tina Zagar

  9. Central Region Cancer Registry of Portugal (ROR-Centro), Portuguese Oncology Institute of Coimbra, Av. Bissaya Barreto 98, 3000-075, Coimbra, Portugal

    Joana Bastos

  10. Department of Health Information and Research, Malta National Cancer Registry, 95 Guardamangia Hill, Guardamangia, MSD 08, Malta

    Domenic Agius

  11. Regional Cancer Registry of Iasi, National Institute of Public Health, 14 Victor Babes Street, 700465, Iasi, Romania

    Margareta Florea

  12. Regional Cancer Registry of Cluj, Oncological Institute “Ion Chiricuta”, Republicii Str no. 34-36, 400015, Cluj Napoca, Romania

    Daniela Coza

  13. First Department of Radiology, Aretaieion Hospital, Medical School, University of Athens, Vasilissis Sofias Str. 76, 11528, Athens, Greece

    Charis Bourgioti

  14. Oncology Department, “Mitera” Childrens Hospital, Erythrou Stavrou 15, 15123, Marousi, Athens, Greece

    Helen Dana

  15. Second Department of Pediatrics, AHEPA General Hospital, Aristotelion University of Thessaloniki, Kiriakidi 1, 54621, Thessaloniki, Greece

    Emmanuel Hatzipantelis

  16. Haematology-Oncology Unit, First Department of Pediatrics, Athens University Medical School, “Aghia Sophia” Children’s Hospital, Thivon and Papadiamantopoulou, 11527, Athens, Greece

    Maria Moschovi

  17. Department of Pathology, Hygeia Hospital, Erythrou Stavrou 6, 15123, Marousi, Athens, Greece

    Savvas Papadopoulos

  18. Department of Neurosurgery, “Aghia Sophia” Children’s Hospital, Thivon and Papadiamantopoulou, 11527, Athens, Greece

    Georgios Sfakianos

  19. Department of Pediatric Hematology and Oncology, Hippokration Hospital, Konstantinoupoleos 49, 54642, Thessaloniki, Greece

    Evgenia Papakonstantinou

  20. Department of Pediatric Haematology-Oncology, “Aghia Sophia” Children’s Hospital, Thivon and Papadiamantopoulou, 11527, Athens, Greece

    Sophia Polychronopoulou

  21. Department of Neurosurgery, “Mitera” Childrens Hospital, Erythrou Stavrou 15, 15123, Marousi, Athens, Greece

    Spyros Sgouros

  22. Histopathology Department, “Aghia Sophia” Children’s Hospital, Thivon and Papadiamantopoulou, 11527, Athens, Greece

    Kalliopi Stefanaki

  23. Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Panepistimiou, 71500, Heraklion, Greece

    Eftichia Stiakaki

  24. Histopathology Department, “Pan. & Agl. Kyriakou” Children’s Hospital, Thivon 18, 11527, Athens, Greece

    Katerina Strantzia

  25. Department of Neurosurgery, St. Luke’s Hospital, Panorama, 55236, Thessaloniki, Greece

    Basilios Zountsas

  26. Department of Pediatric Hematology-Oncology, “Pan. & Agl. Kyriakou” Children’s Hospital, Thivon 18, 11527, Athens, Greece

    Apostolos Pourtsidis

  27. Department of Pathology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527, Athens, Greece

    Eustratios Patsouris

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  1. Marios K. Georgakis
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  2. Maria A. Karalexi
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  3. Eleni I. Kalogirou
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  4. Anton Ryzhov
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  6. Nadya Dimitrova
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  7. Sultan Eser
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  8. Luis Antunes
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  9. Mario Sekerija
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  10. Tina Zagar
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  11. Joana Bastos
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  12. Domenic Agius
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  13. Margareta Florea
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  14. Daniela Coza
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  15. Evdoxia Bouka
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  16. Charis Bourgioti
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  17. Helen Dana
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  18. Emmanuel Hatzipantelis
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  19. Maria Moschovi
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  20. Savvas Papadopoulos
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  21. Georgios Sfakianos
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  22. Evgenia Papakonstantinou
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  23. Sophia Polychronopoulou
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  24. Spyros Sgouros
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  25. Kalliopi Stefanaki
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Correspondence to Eleni Th. Petridou.

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Georgakis, M.K., Karalexi, M.A., Kalogirou, E.I. et al. Incidence, time trends and survival patterns of childhood pilocytic astrocytomas in Southern-Eastern Europe and SEER, US. J Neurooncol 131, 163–175 (2017). https://doi.org/10.1007/s11060-016-2284-9

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