Abstract
Abstract BACKGROUND Despite advances in cancer diagnosis and clinical care, survival for many primary brain and other central nervous system (CNS) tumors remain poor. This study performs a comprehensive survival analysis on these tumors. METHODS Survival differences were determined utilizing the National Program of Cancer Registries Survival Analytic file for all primary brain and other CNS tumors. Overall survival and survival of the 5 most common histopathologies within specific age groups (children ages 0-14 years, adolescents, and young adults [AYA] ages 15-39 years, and older adults ages 40+ years) were determined. Overall survival was compared for three time periods: 2004-2007, 2008-2012, and 2013-2017. Kaplan-Meier and multivariable Cox proportional hazards models were used to generate median survival, hazard ratios (HR) and 95% confidence intervals (CI). Models were adjusted for sex, race/ethnicity, and treatment pattern. Malignant and non-malignant brain tumors were assessed separately. RESULTS Aside from hemangioma and mesenchymal tumors in older adults, no notable changes in survival were observed across the time periods for non-malignant tumors. For malignant brain tumors, significant survival improvements were observed in children with embryonal tumors (logrank p = 0.00028) and in AYA with anaplastic astrocytoma (logrank p = 0.0043). In older adults, significant improvement was observed in the five most common histopathologies except oligodendroglioma. Adjusted for sex, race/ethnicity, and treatment, there were improvements in survival in 2008-2012 and 2013-2017, when compared to 2004-2007, in children and AYA with malignant tumors (Children: HR = 0.92, 95% CI = 0.87-0.98, p = 0.010 in 2008-2012; HR = 0.91, 95% CI = 0.85-0.97, p = 0.005 in 2013-2017; AYA: HR = 0.92, 95% CI = 0.88-0.96, p < 0.001, in 2008-2012; HR = 0.87, 95% CI = 0.83-0.93, p < 0.001 in 2013-2017). CONCLUSIONS Overall survival for malignant brain and other CNS tumors improved slightly in 2013-2017 for all age groups as compared to 2004-2007. No significant changes were observed for non-malignant brain and other CNS tumors.
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