Low-grade Gliomas in Argentina: Incidence, Survival, and Therapeutic Strategies
Low-grade gliomas (LGG) are slow-growing primary brain tumors (WHO grades I-II), and their incidence, survival, and treatment patterns in middle-income settings such as Argentina remain poorly characterized. This retrospective, multicenter study comprises two complementary cohorts:
- Cohort 1: The "captive" population covered under the Hospital Italiano de Buenos Aires Health Plan (January 2011-December 2023) to estimate LGG incidence density.
- Cohort 2: Histologically confirmed LGG patients treated at the major referral centers to describe overall survival (OS) and disease-free survival (DFS) at 1 and 5 years.
Demographic, clinical, pathological, and treatment data will be collected in a centralized REDCap database.
The primary objective is to describe LGG incidence in Argentina and estimate survival using Kaplan-Meier curves. The secondary objectives include characterizing therapeutic strategies, molecular mutations, and prognostic factors through Cox regression analysis. This registry will fill a critical gap in LGG epidemiology in middle-income countries and generate hypotheses for future research.
研究概览
地位
条件
详细说明
Background Low-grade gliomas (LGG) represent approximately 6% of primary central nervous system tumors in adults and exhibit unpredictable biological behavior. Although high-income countries have published LGG incidence and survival data stratified by age, sex, and molecular profile, data from Argentina and other middle-income regions are scarce. IDH mutations and other molecular markers, along with clinical factors (age, seizures, tumor volume, and location) and treatment modalities, influence disease progression and prognosis in these patients.
Objectives
- Primary (Cohort 1): Estimate LGG incidence density in the Hospital Italiano Health Plan population (2011-2023), expressed as cases per 100,000 person-years.
- Primary (Cohort 2): Describe OS and DFS at 1 and 5 years post-diagnosis.
- Secondary: Characterize therapeutic strategies (surgical, chemoradiotherapy, monotherapy), molecular profile (IDH, P53, 1p/19q mutations), and identify prognostic factors associated with OS and DFS using multivariable Cox regression.
Design and Scope
This is a retrospective, multicenter, observational cohort study with two cohorts:
- Cohort 1 (incidence): Retrospective analysis of the Hospital Italiano de Buenos Aires database to identify new LGG cases from January 2011 to December 2023.
- Cohort 2 (survival): Consecutive inclusion of all patients with histologically confirmed LGG treated at the participating centers during the same period.
Population
- Inclusion (Cohort 1): Age ≥ 18 years, HIBA affiliates, ≥ 1 year of documented follow-up.
- Inclusion (Cohort 2): Age ≥ 18 years, histologically confirmed LGG (WHO I-II), ≥ 1 year of documented follow-up.
- Exclusion (both cohorts): Incomplete or uncertain diagnosis per histopathological/genetic criteria.
Data Collection & Management Local investigators will extract demographic, clinical, radiological, pathological, and treatment data from electronic health records. All data will be entered retrospectively into a secure, centralized REDCap database with individual user credentials. Quality control checks (cross-validation with source records) will be performed periodically. After analysis and publication, the database will be permanently deleted to preserve confidentiality.
Key Variables
- Demographics: age, sex, comorbidities, functional status, care setting.
- Tumor Characteristics: volume, location (supra-/infratentorial, hemisphere), histology, IDH/P53 mutation status.
- Treatment Details: extent of resection (total/partial), chemotherapy (agents, cycles, toxicities), radiotherapy (type, dose, fractions).
- Outcomes: time to progression, OS, DFS, postoperative complications, adverse events.
Statistical Analysis
- Cohort 1: Calculate incidence density (cases/person-years) with 95 % confidence intervals by age and sex. Standardization will use INDEC population data.
- Cohort 2: Estimate OS and DFS at 1, and 5 years using Kaplan-Meier methods; report proportions with 95 % CIs. Perform multivariable Cox regression to identify prognostic factors (age, tumor volume, mutation status, treatment type), reporting hazard ratios with 95 % CIs.
- Sample Size: Approximately 180 000 person-years in Cohort 1 (projected 13-14 LGG cases); ≥ 40 patients in Cohort 2 to estimate a 30 % survival rate with ± 10 % precision.
Ethical Considerations The study has a waiver of informed consent under local regulations and CIOMS guidelines. All data will be anonymized using numeric codes and stored on encrypted servers until study completion. In addition, each participating center must obtain approval from its respective ethics committee (IRB/EC) before initiating data collection and provide documentation of such approvals.
研究类型
注册 (估计的)
联系人和位置
学习联系方式
- 姓名:Ivan Alfredo Huespe, MD, MPh
- 电话号码:+5493425382554
- 邮箱:ivan.huespe@hospitalitaliano.org.ar
研究联系人备份
- 姓名:Veronica Ester Monzon, MD
- 电话号码:+5491165846854
- 邮箱:veronica.monzon@hospitalitaliano.org.ar
学习地点
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Buenos Aires F.D.
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Buenos Aires、Buenos Aires F.D.、阿根廷、C1118AAT
- 招聘中
- Hospital Aleman
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接触:
- Daniel Ignacio Ivulich, MD
- 电话号码:+5491161859413
- 邮箱:di.ivulich@gmail.com
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Buenos Aires、Buenos Aires F.D.、阿根廷、C1199ABB
- 招聘中
- Hospital Italiano de Buenos Aires
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接触:
- Ivan Alfredo Huespe, MD, MPh
- 电话号码:+5493425382554
- 邮箱:ivan.huespe@hospitalitaliano.org.ar
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Córdoba Province
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Córdoba、Córdoba Province、阿根廷、X5016KEH
- 招聘中
- Hospital Privado Universitario de Córdoba
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接触:
- Emiliano Tornu, MD
- 电话号码:+5491164073575
- 邮箱:emilianocornu@gmail.com
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Florencio Varela
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Buenos Aires、Florencio Varela、阿根廷、B1888
- 招聘中
- Hospital de Alta Complejidad El Cruce - Dr. Néstor Kirchner
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接触:
- Maximiliano Núñez, MD
- 电话号码:+5492216061422
- 邮箱:maxineuro@gmail.com
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Pilar
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Buenos Aires、Pilar、阿根廷、B1629AHJ
- 招聘中
- Hospital Universitario Austral
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接触:
- Alicia Gira, MD
- 电话号码:+5491126336442
- 邮箱:aliciaroxanagira@gmail.com
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San Justo
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Buenos Aires、San Justo、阿根廷、C1198AAW
- 招聘中
- Hospital Italiano sede San Justo Agustín Rocca
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接触:
- Veronica Ester Monzon, MD
- 电话号码:+5491165846854
- 邮箱:veronica.monzon@hospitalitaliano.org.ar
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参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
取样方法
研究人群
描述
Study population cohort 1
Inclusion Criteria
- Adult patients (≥18 years old) affiliated to the health plan of Hospital Italiano de Buenos Aires.
- Documented clinical follow-up of at least 1 year during the study period.
Exclusion Criteria
- Patients not affiliated to the health plan of the Hospital Italiano de Buenos Aires.
Study population cohort 2
Inclusion Criteria
- Adult patients (≥18 years) with histopathologically confirmed diagnosis of low-grade glioma (WHO grades I and II).
Exclusion Criteria
- Incomplete or doubtful diagnosis based on histopathologic and molecular criteria.
学习计划
研究是如何设计的?
设计细节
队列和干预
团体/队列 |
|---|
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Cohort 1: Incidence cohort
Affiliates of the Hospital Italiano Health Plan from January 2011 to December 2023 used to estimate the incidence density of low-grade gliomas.
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Cohort 2: Survival cohort
Histologically confirmed low-grade glioma patients treated at participating centers, followed retrospectively for up to 5 years to assess overall and disease-free survival.
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Describe the incidence density of LGG
大体时间:January 2011 - December 2023
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The incidence density will be estimated as the number of new cases of LGG divided by the person-time at risk (expressed in patient-years).
The incidence stratified by age group, and sex, with corresponding 95% confidence intervals, will be described.
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January 2011 - December 2023
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Generate an Argentine population projection model
大体时间:January 2011 - December 2023
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A model will be developed to extrapolate the incidence rates of LGG calculated in the HIBA cohort to the general Argentine population.
Initially, specific incidence rates will be estimated, both overall and stratified by age and sex, including 95% confidence intervals to ensure accuracy.
Subsequently, a standardization process will be applied to adjust for demographic differences between the HIBA population and the general population of Argentina, using data from the National Institute of Statistics and Census of Argentina (In Spanish: Instituto Nacional de Estadísticas y Censos [INDEC]).
Finally, the expected cases of LGG will be extrapolated to the national level, generating specific estimates by age and sex per year.
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January 2011 - December 2023
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Describe overall survival (OS) and disease-free survival (DFS)
大体时间:Up to 5 years post-diagnosis
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OS and DFS will be estimated using life tables and plotted with Kaplan-Meier graphs.
Survival and disease-free survival at 1 and 5 years will be reported with the corresponding proportion and 95% confidence interval.
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Up to 5 years post-diagnosis
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Describe the treatment strategies implemented in patients with LGG in public and private institutions
大体时间:January 2011 - December 2023
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Absolute and relative frequencies will be calculated for the treatment strategies used (surgical treatment, chemo-radiotherapy, radiotherapy alone), stratified by type of institution (public or private).
Proportions will be reported with their corresponding 95% confidence interval.
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January 2011 - December 2023
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Evaluate factors associated with shorter time to death or death and relapse
大体时间:Up to 5 years post-diagnosis
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Cox regression models will be used to identify factors associated with shorter time to death and time to death or relapse.
Independent variables such as age, comorbidities, tumor location and volume, molecular status (HDI, 1p/19q codeletion), and type of treatment received will be included.
Results will be reported as Hazard Ratio with 95% confidence intervals.
Data will be plotted with Kaplan-Meier curves.
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Up to 5 years post-diagnosis
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合作者和调查者
调查人员
- 研究主任:Ivan Alfredo Huespe, MD, MPh、Hospital Italiano de Buenos Aires
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- 7339
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
IPD 计划说明
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