Abstract 262: Analysis of demographics, survival and patterns of care of pediatric glioblastoma using National Cancer Database

Abstract

Abstract Background We analyzed the largest clinical database in the United States, the National Cancer Database (NCDB), comprising over 70% of cases diagnosed and/or treated at commission on Cancer approved institutions. We analyzed current hospital-based epidemiologic frequency, survival and patterns of care of pediatric glioblastoma (GBM). Methods Cases included patients 0-19 years between 1998-2011. Inclusion criteria for histology codes included for GBM 9440, 9441 and 9442 (9440 (GBM), 9441(Giant Cell) and 9442 (Sarcomatas component) and tumor sites (C70.0-C72.9, C75.1-C75.3) related to the brain: brain stem, cerebellum, cerebrum, ventricle and brain not otherwise specified (NOS). Kaplan-Meier survival estimates were calculated for each demographic criteria and treatment plan and Cox proportional hazards models were employed to assess the risk of mortality. Demographic variables analyzed were age, gender, race, Hispanic origin, income, education, region and insurance status. Comparisons were made among histologic subtypes and primary site. Results 1173 patients with GBM from age 0 to 19 years were identified from 1998 to 2011 in the United States, of which 21.5%, 24.5% and 54.0% were in age group 0-5, 6-10 and 11-19 years old. The largest group (48%) received advanced care including a combination of radiation (XRT), chemotherapy and surgery. On the other hand, the no treatment group was the smallest comprising of 4% cases. 14% received surgery only, 8% received a combination of XRT and surgery and 9% received a combination of XRT and chemotherapy. Patients that received combination of XRT, chemotherapy and surgery had significantly improved survival when compared to those without any treatment (p = 0.0048). Patients that received surgery or chemotherapy had significantly improved survival as compared to patients that did not receive the above treatments (p = 0.0027). Conclusion We report an extensive demographic and survival analysis of pediatric GBM. Observed difference likely reflect biology across age, gender, race and origin groups. Our analysis demonstrates concern in the delivery of optimal care to a large percentage of pediatric patients. These treatments include surgery and chemotherapy that have demonstrated survival benefits. Adverse effects of chemotherapy and XRT can limit the appropriate administration of treatment. Citation Format: Jigisha Thakkar, Meng Liu, Emily Van Meter Dressler, John L. Villano. Analysis of demographics, survival and patterns of care of pediatric glioblastoma using National Cancer Database [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 262. doi:10.1158/1538-7445.AM2017-262