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The epidemiology of primary and metastatic brain tumors in infancy through childhood

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Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the epidemiology of primary and metastatic pediatric brain tumors in the United States according to the WHO CNS 4th and 5th editions classifications.

Methods

Pediatric patients (age ≤ 14) presenting between 2004 and 2017 with a brain tumor were identified in the National Cancer Database and categorized by NICHD age stages. Patients’ age, sex, race/ethnicity, overall survival, and tumor characteristics were evaluated according to WHO CNS 4th and 5th editions.

Results

23,978 pediatric brain tumor patients were identified. Overall, other (i.e. circumscribed) astrocytic gliomas (21%), diffuse astrocytic/oligodendroglial gliomas (21%; 64% of which were midline), and embryonal tumors (16%) predominated. A minority of brain tumors were of ependymal (6%), glioneuronal & neuronal (6%), germ cell tumor (GCT; 4%), mesenchymal non-meningothelial (2%), cranial nerve (2%), choroid plexus (2%), meningioma (2%), pineal (1%), and hematolymphoid (0.4%) types. GCTs were more likely in patients of Asian/Pacific Islander race/ethnicity. Brain metastases were exceedingly rare, accounting for 1.4% overall, with the most common primary tumor being neuroblastoma (61%) and non-CNS sarcoma (16%). Brain metastatic, choroid plexus, and embryonal tumors peaked during infancy and toddlerhood; whereas diffuse gliomas peaked in middle-late childhood. GCTs and glioneuronal & neuronal tumors uniquely displayed bimodal distributions, with elevated prevalence in both infancy and middle-to-late childhood.

Conclusion

We systematically described the epidemiology of pediatric brain tumors in the context of contemporary classification schema, thereby validating our current understanding and providing key insights.

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Data availability

Data are available by application to the NCDB.

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Acknowledgements

JBI gratefully acknowledges funding support from the National Cancer Institute (K12CA090354) and the Conquer Cancer Foundation/Sontag Foundation. MT is supported by the National Cancer Institute of the National Institutes of Health under award number F32 CA257210. The National Cancer Data Base (NCDB) is a joint project of the Commission on Cancer (CoC) of the American College of Surgeons and the American Cancer Society. The CoC’s NCDB and the hospitals participating in the CoC NCDB are the source of the de-identified data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors.

Funding

No funding was received for conducting this study.

Author information

Author notes

  1. Nayan Lamba and Andrew Groves are co-first authors.

Authors and Affiliations

  1. Department of Radiation Oncology, Harvard Medical School, Boston, MA, United States of America

    Nayan Lamba

  2. Department of Pediatric Oncology, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, MA, United States of America

    Andrew Groves & Kee Kiat Yeo

  3. Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St., Boston, MA, 02115, United States of America

    Matthew Torre & J. Bryan Iorgulescu

Authors
  1. Nayan Lamba
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  2. Andrew Groves
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  4. Kee Kiat Yeo
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  5. J. Bryan Iorgulescu
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Contributions

Conceptualization & supervision: JBI; methodology: JBI; formal analysis and investigation: NL, JBI; critical interpretation of results & writing: all authors.

Corresponding author

Correspondence to J. Bryan Iorgulescu.

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The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethical approval

This study was approved by the Mass General Brigham Institutional Review Board (2015P002352) and conducted in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki.

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NCDB data are de-identified public-use datasets for which consent is not applicable.

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Lamba, N., Groves, A., Torre, M. et al. The epidemiology of primary and metastatic brain tumors in infancy through childhood. J Neurooncol 156, 419–429 (2022). https://doi.org/10.1007/s11060-021-03927-z

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  • DOI: https://doi.org/10.1007/s11060-021-03927-z

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