Nguyen Ha Son, Doan Ninh, Gelsomino Michael, Shabani Saman
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
World Neurosurg. 2017 May;101:599-605. doi: 10.1016/j.wneu.2017.02.019. Epub 2017 Feb 15.
Subependymomas are rare, slow-growing, benign tumors. Because they are scarce, knowledge relating to survival remains lacking. Consequently, we explore the SEER database to evaluate prognostic and treatment factors associated with intracranial subependymoma.
With the SEER-18 registry database, information from all patients with intracranial subependymoma diagnosed during 2004-2013 were extracted, including age, sex, race, occurrence of surgery, extent of primary surgery, receipt of radiation, tumor size, and follow-up data. Age-adjusted incidence rates, overall survival, and cause-specific survival were calculated. Cox proportional hazards model was used for both univariate and multivariate analyses.
Four hundred sixty-six cases were identified. The overall incidence of intracranial subependymoma is 0.055 per 100,000 person-years (95% confidence interval, 0.05-0.06). Through multivariate analysis, age <40 years (hazard ratio [HR], 0.21; P = 0.03), female sex (HR, 0.34; P = 0.03), location within ventricles or near brainstem (HR, 0.49; P = 0.04), and occurrence of surgery (HR, 0.50; P = 0.02) were significant independent positive prognostic factors. Receipt of radiation did not show a significant relationship.
Clinical factors such as younger age, female sex, and location within ventricles or near brain stem demonstrated positive relationship with overall survival. For treatment options, surgery remains a mainstay option. No support for radiation therapy was identified.
室管膜下瘤是罕见的、生长缓慢的良性肿瘤。由于其罕见,关于其生存情况的相关知识仍然匮乏。因此,我们探索监测、流行病学与最终结果(SEER)数据库以评估与颅内室管膜下瘤相关的预后和治疗因素。
利用SEER-18登记数据库,提取2004年至2013年期间诊断为颅内室管膜下瘤的所有患者的信息,包括年龄、性别、种族、手术情况、初次手术范围、放疗情况、肿瘤大小和随访数据。计算年龄调整发病率、总生存率和特定病因生存率。采用Cox比例风险模型进行单因素和多因素分析。
共识别出466例病例。颅内室管膜下瘤的总体发病率为每10万人年0.055(95%置信区间,0.05 - 0.06)。通过多因素分析,年龄<40岁(风险比[HR],0.21;P = 0.03)、女性(HR,0.34;P = 0.03)、位于脑室或脑干附近(HR,0.49;P = 0.04)以及进行手术(HR,0.50;P = 0.02)是显著的独立阳性预后因素。接受放疗未显示出显著关系。
年龄较小、女性以及位于脑室或脑干附近等临床因素与总生存率呈正相关。对于治疗选择,手术仍然是主要选择。未发现支持放疗的依据。