Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.
Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.
Neuro Oncol. 2021 Oct 1;23(10):1765-1776. doi: 10.1093/neuonc/noab067.
Global variations in survival for brain tumors are very wide when all histological types are considered together. Appraisal of international differences should be informed by the distribution of histology, but little is known beyond Europe and North America.
The source for the analysis was the CONCORD database, a program of global surveillance of cancer survival trends, which includes the tumor records of individual patients from more than 300 population-based cancer registries. We considered all patients aged 0-99 years who were diagnosed with a primary brain tumor during 2000-2014, whether malignant or nonmalignant. We presented the histology distribution of these tumors, for patients diagnosed during 2000-2004, 2005-2009, and 2010-2014.
Records were submitted from 60 countries on 5 continents, 67 331 for children and 671 085 for adults. After exclusion of irrelevant morphology codes, the final study population comprised 60 783 children and 602 112 adults. Only 59 of 60 countries covered in CONCORD-3 were included because none of the Mexican records were eligible. We defined 12 histology groups for children, and 11 for adults. In children (0-14 years), the proportion of low-grade astrocytomas ranged between 6% and 50%. Medulloblastoma was the most common subtype in countries where low-grade astrocytoma was less commonly reported. In adults (15-99 years), the proportion of glioblastomas varied between 9% and 69%. International comparisons were made difficult by wide differences in the proportion of tumors with unspecified histology, which accounted for up to 52% of diagnoses in children and up to 65% in adults.
To our knowledge, this is the first account of the global histology distribution of brain tumors, in children and adults. Our findings provide insights into the practices and the quality of cancer registration worldwide.
当考虑所有组织学类型时，全球范围内脑瘤的生存率差异非常大。评估国际差异应该以组织学分布为依据，但除了欧洲和北美以外，我们知之甚少。
本分析的数据源为 CONCORD 数据库，这是一个全球癌症生存趋势监测计划，包含来自 300 多个基于人群的癌症登记处的个体患者肿瘤记录。我们考虑了所有在 2000-2014 年期间诊断为原发性脑肿瘤的 0-99 岁患者，无论其是恶性还是非恶性肿瘤。我们展示了这些肿瘤的组织学分布，对于在 2000-2004 年、2005-2009 年和 2010-2014 年期间诊断的患者分别进行了展示。
该研究记录来自五大洲 60 个国家，其中儿童记录 67331 份，成人记录 671085 份。在排除不相关的形态学代码后，最终的研究人群包括 60783 名儿童和 602112 名成人。由于没有合格的墨西哥记录，CONCORD-3 涵盖的 60 个国家中只有 59 个国家被包括在内。我们为儿童定义了 12 个组织学组，为成人定义了 11 个组织学组。在儿童（0-14 岁）中，低级别星形细胞瘤的比例在 6%至 50%之间。在低级别星形细胞瘤较少报告的国家中，髓母细胞瘤是最常见的亚型。在成人（15-99 岁）中，胶质母细胞瘤的比例在 9%至 69%之间。由于肿瘤的组织学未明比例差异很大，使得国际间的比较变得困难，在儿童中，这一比例高达 52%，在成人中高达 65%。
据我们所知，这是首次对全球儿童和成人脑肿瘤的组织学分布进行的描述。我们的研究结果为全球癌症登记的实践和质量提供了新的认识。
