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儿童少突胶质细胞瘤的预后及预后因素:一项基于人群的研究。

Outcomes and Prognostic Factors in Pediatric Oligodendroglioma: A Population-Based Study.

作者信息

Goel Nicholas J, Abdullah Kalil G, Lang Shih-Shan

机构信息

Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

出版信息

Pediatr Neurosurg. 2018;53(1):24-35. doi: 10.1159/000481458. Epub 2017 Nov 2.

Abstract

BACKGROUND/AIMS: Pediatric oligodendroglioma (pODG) is a rare primary brain tumor that remains poorly understood. Demographics, outcomes, and prognostic factors were analyzed in 346 pODG cases from the Surveillance, Epidemiology, and End Results database.

METHODS

Gender, race, age, tumor location, tumor size, tumor grade, extent of resection, and use of radiotherapy were evaluated with respect to overall survival (OS) by univariate and multivariate analysis. These factors were assessed in the pediatric cohort and 5,753 adult oligodendroglioma cases for comparison.

RESULTS

The mean OS in pODG was 199.6 months. Five- and 10-year survival rates were 85 and 81%. pODG arose less frequently in the frontal lobe than adult tumors (53 vs. 22%) but was more common in the temporal lobe (32 vs. 18%) and extracortical regions (19 vs. 5%, p < 0.0001). pODG presented with smaller size (55 vs. 24%, p < 0.0001) and lower grade (72 vs. 54%, p < 0.0001) than adult tumors. Tumor location, size, grade, use of radiotherapy, and extent of resection were significant prognostic factors. Size and grade were much stronger prognostic factors in children than adults. While children with oligodendroglioma survive much longer than adults on the whole, there was no difference in outcome between children with high-grade tumors and adults with high-grade tumors.

CONCLUSION

pODG differs significantly from adult oligodendroglioma along a number of demographic and tumor factors at a population level, and key prognostic factors influence survival differently in pODG than in adult disease.

摘要

背景/目的:儿童少突胶质细胞瘤(pODG)是一种罕见的原发性脑肿瘤,目前人们对其了解甚少。对监测、流行病学和最终结果数据库中的346例pODG病例进行了人口统计学、预后及预后因素分析。

方法

通过单因素和多因素分析,评估性别、种族、年龄、肿瘤位置、肿瘤大小、肿瘤分级、切除范围和放疗使用情况对总生存期(OS)的影响。在儿童队列和5753例成人少突胶质细胞瘤病例中评估这些因素以作比较。

结果

pODG的平均总生存期为199.6个月。5年和10年生存率分别为85%和81%。与成人肿瘤相比,pODG在额叶的发生率较低(53%对22%),但在颞叶(32%对18%)和皮质外区域更常见(19%对5%,p<0.0001)。与成人肿瘤相比,pODG的大小较小(55%对24%,p<0.0001)且分级较低(72%对54%,p<0.0001)。肿瘤位置、大小、分级、放疗使用情况和切除范围是显著的预后因素。大小和分级在儿童中作为预后因素比在成人中更强。虽然总体上少突胶质细胞瘤患儿的生存期比成人长得多,但高级别肿瘤患儿和高级别肿瘤成人患者的预后没有差异。

结论

在人群水平上,pODG在一些人口统计学和肿瘤因素方面与成人少突胶质细胞瘤有显著差异,关键预后因素对pODG生存的影响与成人疾病不同。

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