Trends in the diagnosis and treatment of pediatric primary spinal cord tumors

Clinical article

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Object

Pediatric primary spinal cord tumors (PSCTs) are rare, with limited comprehensive data regarding incidence and patterns of diagnosis and treatment. The authors evaluated trends in the diagnosis and treatment of PSCTs using a nationwide database.

Methods

The Surveillance, Epidemiology, and End Results (SEER) registry was queried for the years 1975–2007, evaluating clinical patterns in 330 patients 19 years of age or younger in whom a pediatric PSCT had been diagnosed. Histological diagnoses were grouped into pilocytic astrocytoma, other low-grade astrocytoma, ependymoma, and high-grade glioma. Patient demographics, tumor pathology, use of external beam radiation (EBR), and overall survival were analyzed.

Results

The incidence of pediatric PSCT was 0.09 case per 100,000 person-years and did not change over time. Males were more commonly affected than females (58% vs 42%, respectively; p < 0.006). Over the last 3 decades, the specific diagnoses of pilocytic astrocytoma and ependymoma increased, whereas the use of EBR decreased (60.6% from 1975 to 1989 vs 31.3% from 1990 to 2007; p < 0.0001). The 5- and 10-year survival rates did not differ between these time periods.

Conclusions

While the incidence of pediatric PSCT has not changed over time, the pattern of pathological diagnoses has shifted, and pilocytic astrocytoma and ependymoma have been increasingly diagnosed. The use of EBR over time has declined. Relative survival of patients with low-grade PSCT has remained high regardless of the pathological diagnosis.

Abbreviations used in this paper:CBTRUS = Central Brain Tumor Registry of the United States; EBR = external beam radiation; PSCT = primary spinal cord tumor; SEER = Surveillance, Epidemiology, and End Results.
Article Information

Contributor Notes

Address correspondence to: Melanie G. Hayden Gephart, M.D., M.A.S., Department of Neurosurgery, Stanford University School of Medicine, 300 Pasteur Drive, MC 5327, Stanford, California 94305-5327. email: mghayden@gmail.com.Please include this information when citing this paper: published online October 12, 2012; DOI: 10.3171/2012.9.PEDS1272.
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