Jagtiani Pemla, Karabacak Mert, Bahadir Zeynep, Bhimani Abhiraj D, Morgenstern Peter, Margetis Konstantinos
School of Medicine, SUNY Downstate Health Sciences University, United States.
Department of Neurosurgery, Mount Sinai Health System, New York, NY, United States.
Clin Neurol Neurosurg. 2024 Sep;244:108457. doi: 10.1016/j.clineuro.2024.108457. Epub 2024 Jul 18.
Query the National Cancer Database (NCDB) to delineate epidemiologic frequency, care patterns, and survival outcomes of pediatric intramedullary spinal cord tumors (IMSCTs).
IMSCTs included ependymoma, astrocytoma, and hemangioblastoma. We examined data from the NCDB spanning 2004-2018, focusing on IMSCT in children aged 0-21 years. Our analysis included logistic and Poisson regression, Kaplan-Meier survival estimates, and Cox proportional hazards models.
This study included 1066 patients aged 0-21 years. 59.4 % of patients were male, while 83.1 % were white. The most common tumor histology was ependymoma (57.5 %), followed by astrocytoma (36.1 %) and hemangioblastoma (6.4 %). 24.9 % of patients received radiotherapy, with radiotherapy utilization being highest among patients aged 6-10 years. Chemotherapy utilization was highest in patients aged 0-5 years. 87.2 % of patients underwent surgical resection, with higher rates in patients aged 16-21 years. Overall survival did not differ significantly between resected and non-resected patients (p = 0.315). Patients in rural areas had worse OS than those in metro areas (HR = 4.42, p = 0.048). Patients with astrocytoma had worse OS compared to other histologies (HR = 2.21, p = 0.003). Astrocytoma patients were over twice as likely to have prolonged LOS compared to ependymoma patients (OR = 2.204, p < 0.001).
In summary, our analysis utilizing the NCDB database provides a comprehensive overview of demographics, care patterns, and outcomes for the largest cohort of pediatric IMSCTs to date. These insights underscore the complexity of managing IMSCTs and emphasize the need for tailored approaches to improve patient outcomes.
查询国家癌症数据库（NCDB），以描述儿童脊髓髓内肿瘤（IMSCTs）的流行病学频率、治疗模式和生存结果。
IMSCTs包括室管膜瘤、星形细胞瘤和血管母细胞瘤。我们研究了NCDB中2004 - 2018年的数据，重点关注0 - 21岁儿童的IMSCTs。我们的分析包括逻辑回归和泊松回归、Kaplan - Meier生存估计以及Cox比例风险模型。
本研究纳入了1066例0 - 21岁的患者。59.4%的患者为男性，83.1%为白人。最常见的肿瘤组织学类型是室管膜瘤（57.5%），其次是星形细胞瘤（36.1%）和血管母细胞瘤（6.4%）。24.9%的患者接受了放疗，放疗使用率在6 - 10岁的患者中最高。化疗使用率在0 - 5岁的患者中最高。87.2%的患者接受了手术切除，16 - 21岁的患者切除率更高。切除和未切除患者的总生存率无显著差异（p = 0.315）。农村地区的患者总生存期比城市地区的患者更差（HR = 4.42，p = 0.048）。与其他组织学类型相比，星形细胞瘤患者的总生存期更差（HR = 2.21，p = 0.003）。与室管膜瘤患者相比，星形细胞瘤患者住院时间延长的可能性是其两倍多（OR = 2.204，p < 0.001）。
总之，我们利用NCDB数据库进行的分析提供了迄今为止最大队列儿童IMSCTs的人口统计学、治疗模式和结果的全面概述。这些见解强调了管理IMSCTs的复杂性，并强调需要采用量身定制的方法来改善患者预后。
