Radiation Oncology Service, Catalan Institute of Oncology, Girona, Spain.
J Neurooncol. 2011 Jan;101(1):117-23. doi: 10.1007/s11060-010-0240-7. Epub 2010 Jun 11.
The purpose of this study was to describe the incidence and survival of primary Central Nervous System (CNS) malignancies using data from the population-based cancer registry for Girona province (north-east Spain).We included all cases of primary CNS malignancies registered between 1994 and 2005. Pathological diagnoses were reviewed and grouped according to the 2007 WHO Classification. Meningeal, soft tissue tumours, spinal cord tumours and primary CNS lymphoma were not included. Cases notified only by death certificate were excluded from the survival analysis. Kaplan and Meier survival curves were calculated from date of diagnosis to death or end of study (31 December 2005), as was relative survival. A total of 493 new CNS cancer patients were registered during the study period: 49.3% astrocytic, 3.4% oligodendroglial and oligoastrocytic tumours, 2.6% ependimal tumours, 3.7% embryonal tumours, 0.2% choroid plexus and 41% without histological confirmation. The mean age (in years) for embryonal tumours was 18.17 years, these being the younger patients in the sample, and 66.34 years for those without histological confirmation, the older patients. Overall, the age standardised incidence rate was 5.88 cases/100,000 people/year (men = 6.81; women = 4.99) with an increasing trend by age until the 70-74 age group. Five-year observed survival rates were: 14.6% for astrocytic tumours, 35.7% for oligodendroglial and oligoastrocytic tumours, 41.0% for ependymal tumours, 32.4% for embryonal tumours and 7.5% for those without histological confirmation (log rank test: P < 0.001). Five-year observed survival rates for astrocytic tumours were analyzed separately by tumour grading, with 37% for diffuse astrocytoma, 7.1% for anaplastic astrocytoma and 4.7% for glioblastoma (log rank test: P < 0.001).Our results show that astrocytic tumours are most frequently diagnosed and glioblastoma patients have the worst survival figures for the area covered by our population cancer registry.The high observed incidence of histologically unverified tumours is most probably due to easy access to state of the art CNS imaging in our area.
本研究的目的是描述使用来自西班牙东北部赫罗纳省（Girona province）基于人群的癌症登记处的数据，原发性中枢神经系统（CNS）恶性肿瘤的发病率和生存率。我们纳入了 1994 年至 2005 年间登记的所有原发性 CNS 恶性肿瘤病例。对病理诊断进行了回顾，并根据 2007 年 WHO 分类进行了分组。脑膜、软组织肿瘤、脊髓肿瘤和原发性 CNS 淋巴瘤不包括在内。仅通过死亡证明报告的病例被排除在生存分析之外。从诊断日期到死亡或研究结束（2005 年 12 月 31 日）计算 Kaplan-Meier 生存曲线和相对生存率。在研究期间共登记了 493 例新的 CNS 癌症患者：星形细胞瘤占 49.3%，少突胶质细胞瘤和少突星形细胞瘤占 3.4%，室管膜瘤占 2.6%，胚胎性肿瘤占 3.7%，脉络丛肿瘤占 0.2%，41%无组织学证实。胚胎性肿瘤的平均年龄（岁）为 18.17 岁，是样本中较年轻的患者，而无组织学证实的患者年龄最大，为 66.34 岁。总体而言，年龄标准化发病率为 5.88 例/100,000 人/年（男性=6.81；女性=4.99），呈年龄递增趋势，直至 70-74 岁年龄组。5 年观察生存率为：星形细胞瘤为 14.6%，少突胶质细胞瘤和少突星形细胞瘤为 35.7%，室管膜瘤为 41.0%，胚胎性肿瘤为 32.4%，无组织学证实的肿瘤为 7.5%（对数秩检验：P<0.001）。星形细胞瘤的 5 年观察生存率按肿瘤分级进行单独分析，弥漫性星形细胞瘤为 37%，间变性星形细胞瘤为 7.1%，胶质母细胞瘤为 4.7%（对数秩检验：P<0.001）。我们的结果表明，星形细胞瘤最常被诊断，而在我们的人群癌症登记处覆盖的区域内，胶质母细胞瘤患者的生存率最差。组织学上未经证实的肿瘤的高观察发病率很可能是由于我们地区能够获得先进的中枢神经系统成像技术。
