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Age is a major determinant for poor prognosis in patients with pilocytic astrocytoma: a SEER population study

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Abstract

Background Pilocytic astrocytomas (PAs) are central nervous system tumors with variable prognosis and poorly understood risk factors. Little evidence exists regarding the effect of age on mortality in PA. Therefore, we conducted a thorough characterization of PA in the US. Methods We queried the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2018 to extract age-adjusted incidence rate (AAIR), age-adjusted mortality rate (AAMR), and survival data on PA. The age group comparisons for each measure varied depending on available SEER data. We compared trends in AAIR and AAMR by two age groups (children, 0–19 years; adults, 20 + years) and by sex. The cumulative incidence function and the Fine-Gray competing risk model were applied by 0–19, 20–39, 40–59, and 60 + years of age groups. Results This study included 5211 incident PA and 462 PA-specific deaths between 2000 and 2018. Trends in AAIRs and AAMRs were almost constant between 2000 and 2018. Average AAIRs had a sharp peak in 1–4 years of age groups, whereas AAMRs had a gradual peak in 80–84 years of age groups. Age groups, tumor location, and race/ethnicity were significantly associated with PA-specific death, whereas only age was associated with other cause of deaths. Conclusions Trends in AAIRs and AAMRs were constant regardless of age. PAs in older populations, especially over 60 years old, have higher incidence of death than those in younger populations.

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Abbreviations

AAIR:

Age-adjusted incidence rate

AAMR:

Age-adjusted mortality rate

AAPC:

Average annual percentage change

CODs:

Cause of deaths

MC AAP:

Methylation class with anaplastic astrocytoma with piloid features

MIR:

Mortality-to-incidence ratio

PA:

Pilocytic astrocytoma

SEER:

The Surveillance, Epidemiology, and End results

SHR:

Subdistribution hazard ratio

WHO:

World Health Organization

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Funding

This study was supported by JSPS KAKENHI Grant to Y.O. (Nos. JP21K20803 and JP22K16687). Other authors certify that they have no grants, equipment, drugs, and other support that facilitated the conduct of the work described in the article or the writing of the article itself.

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Authors and Affiliations

  1. Department of Neurosurgery and Neuroendovascular Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, 730-8518, Japan

    Yusuke Tomita & Nobuyuki Hirotsune

  2. Department of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan

    Yusuke Tomita, Yasuki Suruga, Joji Ishida, Kentaro Fujii, Isao Date & Yoshihiro Otani

  3. Division of Epidemiology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA

    Elizabeth A. Hibler

  4. Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan

    Kaishi Satomi

  5. Department of Brain Diseases Translational Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan

    Koichi Ichimura

  6. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA

    Yoshihiro Tanaka

  7. Center for Arrhythmia Research, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA

    Yoshihiro Tanaka

Authors
  1. Yusuke Tomita
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Contributions

YO contributed to the study concept and design. Data collection was performed by YT, and statistical analysis was conducted by YT and YT. The first draft of the manuscript was written by YT and YT, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Yoshihiro Tanaka or Yoshihiro Otani.

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Competing interests

The authors declare no competing interests.

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The authors declare that they have no conflict of interest.

Ethical approval

This study utilized deidentified data from the SEER database that is a publicly available. This secondary analysis of deidentified data was reviewed and approved by the Okayama University ethics board.

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Tomita, Y., Hibler, E.A., Suruga, Y. et al. Age is a major determinant for poor prognosis in patients with pilocytic astrocytoma: a SEER population study. Clin Exp Med 23, 2301–2309 (2023). https://doi.org/10.1007/s10238-022-00882-5

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  • DOI: https://doi.org/10.1007/s10238-022-00882-5

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