Incidence patterns for primary malignant spinal cord gliomas: a Surveillance, Epidemiology, and End Results study

Clinical article

View More View Less
  • 1 Case Western Reserve University School of Medicine;
  • 2 Neurological Institute, University Hospitals Case Medical Center, Cleveland, Ohio;
  • 3 Department of Neurosurgery, Iowa Spine and Brain Institute, Waterloo, Iowa; and
  • 4 Case Comprehensive Cancer Center, Cleveland, Ohio
Restricted access

Purchase Now

USD  $45.00

Spine - 1 year subscription bundle (Individuals Only)

USD  $369.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

Object

Primary malignant spinal glioma represents a significant clinical challenge due to the devastating effect on clinical outcomes in the majority of cases. As they are infrequently encountered in any one center, there has been limited population-based data analysis on the incidence patterns of these aggressive tumors. The objective of this study was to use publically available Surveillance, Epidemiology and End Results (SEER) program data to examine the overall incidence and incidence patterns over time with regard to age at diagnosis, sex, race, primary site of tumor, and histological subtype in patients in whom primary malignant spinal cord gliomas were diagnosed between 1973 and 2006.

Methods

The study population of interest was limited to primary, malignant, pathologically confirmed spinal cord gliomas based on data drawn from the SEER 9 standard registries for patients diagnosed between 1973 and 2006. Variables of interest included age at diagnosis, sex, race, primary site of tumor, and histological subtype of tumor. The SEER*Stat 6.5.2 program was used to calculate frequencies, age-adjusted incidence rates with 95% CIs, and annual percentage change (APC) statistics with a 2-sided p value. In addition, linear correlation coefficients (R2) were calculated for the time association stratified by variables of interest.

Results

The overall age-adjusted incidence rate for primary malignant spinal gliomas was 0.12 per 100,000, which increased significantly over the study period (APC = 1.74; p = 0.0004; R2 = 0.36). The incidence was highest in patients diagnosed at ages 35–49 (0.17 per 100,000), males (0.14 per 100,000), whites (0.13 per 100,000), and those with ependymomas (0.07 per 100,000). Over the study period, the incidence of ependymomas increased significantly (APC = 3.17; p < 0.0001; R2 = 0.58) as did the incidence of these tumors in whites (APC = 2.13; p = 0.0001) and for both males (APC = 1.90, p value < 0.0001) and females (APC = 1.60, p < 0.0001). The authors found no significant changes in the incidence over time by age of diagnosis.

Conclusions

This study demonstrates an increasing overall incidence of primary, malignant spinal cord glioma over the past 3 decades. Notably, for ependymoma the incidence has increased, whereas the incidence of most other glioma subtypes remained stable. This may be due to improved diagnostic and surgical techniques, changes in histological classification criteria, and changes in neuropathology diagnostic criteria. Although primary, malignant spinal cord gliomas are rare, an improved understanding of the incidence will assist investigators and clinicians in planning potential studies and preparing for allocation of resources to care for these challenging patients.

Abbreviations used in this paper: APC = annual percentage change; NOS = not otherwise specified; SEER = Surveillance, Epidemiology and End Results.

Spine - 1 year subscription bundle (Individuals Only)

USD  $369.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

* Drs. Hsu and Quattrone contributed equally to this work.

Address correspondence to: Jill S. Barnholtz-Sloan, Ph.D., Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, 11000 Euclid Avenue—Wearn 152, Cleveland, Ohio 44106. email: jsb42@case.edu.

Please include this information when citing this paper: published online March 11, 2011; DOI: 10.3171/2011.1.SPINE10351.

  • 1

    Barnholtz-Sloan JS, , Sloan AE, & Schwartz AG: Relative survival rates and patterns of diagnosis analyzed by time period for individuals with primary malignant brain tumor, 1973–1997. J Neurosurg 99:458466, 2003

    • Search Google Scholar
    • Export Citation
  • 2

    Burchard EG, , Ziv E, , Coyle N, , Gomez SL, , Tang H, & Karter AJ, : The importance of race and ethnic background in biomedical research and clinical practice. N Engl J Med 348:11701175, 2003

    • Search Google Scholar
    • Export Citation
  • 3

    Castillo MS, , Davis FG, , Surawicz T, , Bruner JM, , Bigner S, & Coons S, : Consistency of primary brain tumor diagnoses and codes in cancer surveillance systems. Neuroepidemiology 23:8593, 2004

    • Search Google Scholar
    • Export Citation
  • 4

    Central Brain Tumor Registry of the United States: CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2004–2006 Hinsdale, IL, Central Brain Tumor Registry of the United States, 2010. (http://www.cbtrus.org/2010-NPCR-SEER/CBTRUS-WEBREPORT-Final-3-2-10.pdf) [Accessed January 20, 2011]

    • Search Google Scholar
    • Export Citation
  • 5

    Chi JG: Acardiac twins: an analysis of 10 cases. J Korean Med Sci 4:203216, 1989

  • 6

    Coons SW, , Johnson PC, , Scheithauer BW, , Yates AJ, & Pearl DK: Improving diagnostic accuracy and interobserver concordance in the classification and grading of primary gliomas. Cancer 79:13811393, 1997

    • Search Google Scholar
    • Export Citation
  • 7

    Elia-Pasquet S, , Provost D, , Jaffré A, , Loiseau H, , Vital A, & Kantor G, : Incidence of central nervous system tumors in Gironde, France. Neuroepidemiology 23:110117, 2004

    • Search Google Scholar
    • Export Citation
  • 8

    Farwell JR, , Dohrmann GJ, & Flannery JT: Central nervous system tumors in children. Cancer 40:31233132, 1977

  • 9

    Helseth A, & Mørk SJ: Primary intraspinal neoplasms in Norway, 1955 to 1986. A population-based survey of 467 patients. J Neurosurg 71:842845, 1989

    • Search Google Scholar
    • Export Citation
  • 10

    Henson JW: Spinal cord gliomas. Curr Opin Neurol 14:679682, 2001

  • 11

    Jorde LB, Human genetic variation and disease. Meyers RA: Encyclopedia of Molecular Biology and Molecular Medicine ed 2 Weinheim, Wiley-VCH Publishers, 2005. 6:323337

    • Search Google Scholar
    • Export Citation
  • 12

    Kirsch-Volders M, , Bonassi S, , Herceg Z, , Hirvonen A, , Möller L, & Phillips DH: Gender-related differences in response to mutagens and carcinogens. Mutagenesis 25:213221, 2010

    • Search Google Scholar
    • Export Citation
  • 13

    Liigant A, , Asser T, , Kulla A, & Kaasik AE: Epidemiology of primary central nervous system tumors in Estonia. Neuroepidemiology 19:300311, 2000

    • Search Google Scholar
    • Export Citation
  • 14

    Louis DN, , Ohgaki H, , Wiestler OD, , Cavenee WK, , Burger PC, & Jouvet A, : The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 114:97109, 2007

    • Search Google Scholar
    • Export Citation
  • 15

    Milano MT, , Johnson MD, , Sul J, , Mohile NA, , Korones DN, & Okunieff P, : Primary spinal cord glioma: a Surveillance, Epidemiology, and End Results database study. J Neurooncol 98:8392, 2010

    • Search Google Scholar
    • Export Citation
  • 16

    Mountain JL, & Risch N: Assessing genetic contributions to phenotypic differences among ‘racial’ and ‘ethnic’ groups. Nat Genet 36:11 Suppl S48S53, 2004

    • Search Google Scholar
    • Export Citation
  • 17

    National Cancer Institute: Surveillance, Epidemiology and End Results (SEER) (http://www.seer.cancer.gov) [Accessed January 20, 2011]

  • 18

    Schellinger KA, , Propp JM, , Villano JL, & McCarthy BJ: Descriptive epidemiology of primary spinal cord tumors. J Neurooncol 87:173179, 2008

    • Search Google Scholar
    • Export Citation
  • 19

    Sevick RJ, & Wallace CJ: MR imaging of neoplasms of the lumbar spine. Magn Reson Imaging Clin N Am 7:539553, ix, 1999

  • 20

    Shrivastava RK, , Epstein FJ, , Perin NI, , Post KD, & Jallo GI: Intramedullary spinal cord tumors in patients older than 50 years of age: management and outcome analysis. J Neurosurg Spine 2:249255, 2005

    • Search Google Scholar
    • Export Citation
  • 21

    Sloof JL, , Kernohan JW, & MacCarty CS: Primary Intramedullary Tumours of the Spinal Cord and Filum Terminale London, WB Saunders, 1964

  • 22

    Smith MA, , Freidlin B, , Ries LA, & Simon R: Trends in reported incidence of primary malignant brain tumors in children in the United States. J Natl Cancer Inst 90:12691277, 1998

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 328 191 11
Full Text Views 90 10 0
PDF Downloads 116 2 0
EPUB Downloads 0 0 0