Survival trends of grade I, II, and III astrocytoma patients and associated clinical practice patterns between 1999 and 2010: A SEER-based analysis

Xuezhi Dong, Abraham Noorbakhsh, Brian R Hirshman, Tianzan Zhou, Jessica A Tang, David C Chang, Bob S Carter, Clark C Chen, Xuezhi Dong, Abraham Noorbakhsh, Brian R Hirshman, Tianzan Zhou, Jessica A Tang, David C Chang, Bob S Carter, Clark C Chen

Abstract

Background: The survival trends and the patterns of clinical practice pertaining to radiation therapy and surgical resection for WHO grade I, II, and III astrocytoma patients remain poorly characterized.

Methods: Using the Surveillance, Epidemiology and End Results (SEER) database, we identified 2497 grade I, 4113 grade II, and 2755 grade III astrocytomas during the period of 1999-2010. Time-trend analyses were performed for overall survival, radiation treatment (RT), and the extent of surgical resection (EOR).

Results: While overall survival of grade I astrocytoma patients remained unchanged during the study period, we observed improved overall survival for grade II and III astrocytoma patients (Tarone-Ware P < .05). The median survival increased from 44 to 57 months and from 15 to 24 months for grade II and III astrocytoma patients, respectively. The differences in survival remained significant after adjusting for pertinent variables including age, ethnicity, marital status, sex, tumor size, tumor location, EOR, and RT status. The pattern of clinical practice in terms of EOR for grade II and III astrocytoma patients did not change significantly during this study period. However, there was decreased RT utilization as treatment for grade II astrocytoma patients after 2005.

Conclusion: Results from the SEER database indicate that there were improvements in the overall survival of grade II and III astrocytoma patients over the past decade. Analysis of the clinical practice patterns identified potential opportunities for impacting the clinical course of these patients.

Keywords: WHO grade I, II, III astrocytomas; population-based SEER database; practice pattern; survival.

© The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Figures

Fig. 1.
Fig. 1.
(A) Kaplan-Meier plots of 10-year survival by time period for patients with WHO grade I-IV astrocytomas. Note the survival rate (y-axis) ranges from 0.85 to 1 for grade I pilocytic astrocytoma, from 0.25 to 1 for grade II diffuse astrocytoma, and from 0 to 1 for grade III anaplastic astrocytoma and grade IV glioblastoma. (B) Kaplan-Meier plots of 2-year survival by time period for patients with WHO grade I-IV astrocytomas. Note the survival rate (y-axis) ranges from 0.9 to 1 for grade I pilocytic astrocytoma, from 0.5 to 1 for grade II diffuse astrocytoma, from 0.25 to 1 for grade III anaplastic astrocytoma, and from 0 to 1 for grade IV glioblastoma.
Fig. 1.
Fig. 1.
(A) Kaplan-Meier plots of 10-year survival by time period for patients with WHO grade I-IV astrocytomas. Note the survival rate (y-axis) ranges from 0.85 to 1 for grade I pilocytic astrocytoma, from 0.25 to 1 for grade II diffuse astrocytoma, and from 0 to 1 for grade III anaplastic astrocytoma and grade IV glioblastoma. (B) Kaplan-Meier plots of 2-year survival by time period for patients with WHO grade I-IV astrocytomas. Note the survival rate (y-axis) ranges from 0.9 to 1 for grade I pilocytic astrocytoma, from 0.5 to 1 for grade II diffuse astrocytoma, from 0.25 to 1 for grade III anaplastic astrocytoma, and from 0 to 1 for grade IV glioblastoma.

References

    1. Dolecek TA, Propp JM, Stroup NE et al. . CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005–2009. Neuro Oncol. 2012;14:Suppl 5:v1–49.
    1. Bartek J Jr., Ng K, Bartek J et al. . Key concepts in glioblastoma therapy. J Neurol Neurosurg Psychiatry. 2012;83(7):753–760.
    1. Ng K, Kim R, Kesari S et al. . Genomic profiling of glioblastoma: convergence of fundamental biologic tenets and novel insights. J Neurooncol. 2012;107(1):1–12.
    1. Louis DN, Ohgaki H, Wiestler OD et al. . The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 2007;114(2):97–109.
    1. Ohgaki H, Kleihues P. Epidemiology and etiology of gliomas. Acta Neuropathol. 2005;109(1):93–108.
    1. Keles GE, Chang EF, Lamborn KR et al. . Volumetric extent of resection and residual contrast enhancement on initial surgery as predictors of outcome in adult patients with hemispheric anaplastic astrocytoma. J Neurosurg. 2006;105(1):34–40.
    1. Hegi ME, Diserens AC, Gorlia T et al. . MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med. 2005;352(10):997–1003.
    1. Karajannis M, Allen JC, Newcomb EW. Treatment of pediatric brain tumors. J Cell Physiol. 2008;217(3):584–589.
    1. McGirt MJ, Chaichana KL, Attenello FJ et al. . Extent of surgical resection is independently associated with survival in patients with hemispheric infiltrating low-grade gliomas. Neurosurgery. 2008;63(4):700–707, author reply 707–708.
    1. Smith JS, Chang EF, Lamborn KR et al. . Role of extent of resection in the long-term outcome of low-grade hemispheric gliomas. J Clin Oncol. 2008;26(8):1338–1345.
    1. Nomiya T, Nemoto K, Kumabe T et al. . Prognostic significance of surgery and radiation therapy in cases of anaplastic astrocytoma: retrospective analysis of 170 cases. J Neurosurg. 2007;106(4):575–581.
    1. Sanai N, Berger MS. Glioma extent of resection and its impact on patient outcome. Neurosurgery. 2008;62(4):753–764. discussion 264–756.
    1. Sanai N, Chang S, Berger MS. Low-grade gliomas in adults. J Neurosurg. 2011;115(5):948–965.
    1. Pedersen CL, Romner B. Current treatment of low grade astrocytoma: a review. Clin Neurol Neurosurg. 2013;115(1):1–8.
    1. Wen PY, Kesari S. Malignant gliomas in adults. N Engl J Med. 2008;359(5):492–507.
    1. Noorbakhsh A, Tang JA, Marcus LP et al. . Gross-total resection outcomes in an elderly population with glioblastoma: a SEER-based analysis. J Neurosurg. 2014;120(1):31–39.
    1. Koshy M, Villano JL, Dolecek TA et al. . Improved survival time trends for glioblastoma using the SEER 17 population-based registries. J Neurooncol. 2012;107(1):207–212.
    1. Johnson DR, O'Neill BP. Glioblastoma survival in the United States before and during the temozolomide era. J Neurooncol. 2012;107(2):359–364.
    1. Johnson DR, Leeper HE, Uhm JH. Glioblastoma survival in the United States improved after Food and Drug Administration approval of bevacizumab: a population-based analysis. Cancer. 2013;119(19):3489–3495.
    1. Darefsky AS, King JT Jr., Dubrow R. Adult glioblastoma multiforme survival in the temozolomide era: a population-based analysis of Surveillance, Epidemiology, and End Results registries. Cancer. 2012;118(8):2163–2172.
    1. Surveillance, Epidemiology, and End Results (SEER) Program () Research Data (1973–2010), National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch. Published April 2013, based on the November 2012 submission. Downloaded as ASCII text data file on August 9, 2013.
    1. Surveilance, Epidemiology, and End Results (SEER) Program Overview. SEER Program Web site. . Accessed on July 21, 2013.
    1. SEER Data 1973–2010. SEER Program Web site. . Accessed on July 21, 2013.
    1. Ostrom QT, Gittleman H, Farah P et al. . CBTRUS statistical report: Primary brain and central nervous system tumors diagnosed in the United States in 2006–2010. Neuro Oncol. 2013;15(Suppl 2):ii1–i56.
    1. SEER Appendix C: Site Specific Coding Modules. SEER Program Web site . Accessed on July 21, 2013.
    1. SEER Historical Staging and Coding Manuals. SEER Program Web site . Accessed on July 21, 2013.
    1. StataCorp. 2009. Stata Statistical Software: Release 11. College Station, TX: StataCorp LP.
    1. Stupp R, Mason WP, van den Bent MJ et al. . Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005;352(10):987–996.
    1. van den Bent MJ. Anaplastic oligodendroglioma and oligoastrocytoma. Neurol Clin. 2007;25(4):1089–1109, ix-x.
    1. Cairncross G, Macdonald D, Ludwin S et al. . Chemotherapy for anaplastic oligodendroglioma. National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol. 1994;12(10):2013–2021.
    1. Cairncross JG, Ueki K, Zlatescu MC et al. . Specific genetic predictors of chemotherapeutic response and survival in patients with anaplastic oligodendrogliomas. J Natl Cancer Inst. 1998;90(19):1473–1479.
    1. Gorlia T, Delattre JY, Brandes AA et al. . New clinical, pathological and molecular prognostic models and calculators in patients with locally diagnosed anaplastic oligodendroglioma or oligoastrocytoma. A prognostic factor analysis of European Organisation for Research and Treatment of Cancer Brain Tumour Group Study 26951. Eur J Cancer. 2013;49(16):3477–3485.
    1. van den Bent MJ, Kros JM, Heimans JJ et al. . Response rate and prognostic factors of recurrent oligodendroglioma treated with procarbazine, CCNU, and vincristine chemotherapy. Dutch Neuro-oncology Group. Neurology. 1998;51(4):1140–1145.
    1. van den Bent MJ, Looijenga LH, Langenberg K et al. . Chromosomal anomalies in oligodendroglial tumors are correlated with clinical features. Cancer. 2003;97(5):1276–1284.
    1. Youland RS, Schomas DA, Brown PD et al. . Changes in presentation, treatment, and outcomes of adult low-grade gliomas over the past fifty years. Neuro Oncol. 2013;15(8):1102–1110.
    1. Claus EB, Black PM. Survival rates and patterns of care for patients diagnosed with supratentorial low-grade gliomas: data from the SEER program, 1973–2001. Cancer. 2006;106(6):1358–1363.
    1. van den Bent MJ, Afra D, de Witte O et al. . Long-term efficacy of early versus delayed radiotherapy for low-grade astrocytoma and oligodendroglioma in adults: the EORTC 22845 randomised trial. Lancet. 2005;366(9490):985–990.
    1. Pace A, Vidiri A, Galie E et al. . Temozolomide chemotherapy for progressive low-grade glioma: clinical benefits and radiological response. Ann Oncol. 2003;14(12):1722–1726.
    1. Quinn JA, Reardon DA, Friedman AH et al. . Phase II trial of temozolomide in patients with progressive low-grade glioma. J Clin Oncol. 2003;21(4):646–651.
    1. Kaloshi G, Benouaich-Amiel A, Diakite F et al. . Temozolomide for low-grade gliomas: predictive impact of 1p/19q loss on response and outcome. Neurology. 2007;68(21):1831–1836.
    1. Lashkari HP, Saso S, Moreno L et al. . Using different schedules of Temozolomide to treat low grade gliomas: systematic review of their efficacy and toxicity. J Neurooncol. 2011;105(2):135–147.
    1. Chen CC, Motegi A, Hasegawa Y et al. . Genetic analysis of ionizing radiation-induced mutagenesis in Saccharomyces cerevisiae reveals TransLesion Synthesis (TLS) independent of PCNA K164 SUMOylation and ubiquitination. DNA Repair (Amst). 2006;5(12):1475–1488.
    1. Hardesty DA, Sanai N. The value of glioma extent of resection in the modern neurosurgical era. Front Neurol. 2012;3:140.
    1. Capelle L, Fontaine D, Mandonnet E et al. . Spontaneous and therapeutic prognostic factors in adult hemispheric World Health Organization Grade II gliomas: a series of 1097 cases: clinical article. J Neurosurg. 2013;118(6):1157–1168.
    1. van Veelen ML, Avezaat CJ, Kros JM et al. . Supratentorial low grade astrocytoma: prognostic factors, dedifferentiation, and the issue of early versus late surgery. J Neurol Neurosurg Psychiatry. 1998;64(5):581–587.
    1. Claus EB, Horlacher A, Hsu L et al. . Survival rates in patients with low-grade glioma after intraoperative magnetic resonance image guidance. Cancer. 2005;103(6):1227–1233.
    1. Weller M, Wick W. Neuro-oncology in 2013: improving outcome in newly diagnosed malignant glioma. Nat Rev Neurol. 2014;10(2):68–70.
    1. Van Meir EG, Hadjipanayis CG, Norden AD et al. . Exciting new advances in neuro-oncology: the avenue to a cure for malignant glioma. CA Cancer J Clin. 2010;60(3):166–193.
    1. Quaday KA, Salzman JG, Gordon BD. Magnetic resonance imaging and computed tomography utilization trends in an academic ED. Am J Emerg Med. 2014;32(6):524–528.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel