Epidemiology and risk stratification of low-grade gliomas in the United States, 2004-2019: A competing-risk regression model for survival analysis

Frontiers in Oncology

Oncology

Xinyu Hong¹  Zhixin Zhan¹  Hong Yan²  Weijia Yan³  Junguo Cao⁴ 

[1] Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China;Shaanxi Eye Hospital (Xi’an People’s Hospital), Affiliated Xi'an Fourth Hospital, Northwestern Polytechnical University; Affiliated Guangren Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi, China;Shaanxi Eye Hospital (Xi’an People’s Hospital), Affiliated Xi'an Fourth Hospital, Northwestern Polytechnical University; Affiliated Guangren Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi, China;Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany;Shaanxi Eye Hospital (Xi’an People’s Hospital), Affiliated Xi'an Fourth Hospital, Northwestern Polytechnical University; Affiliated Guangren Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi, China;Division of Experimental Neurosurgery, Department of Neurosurgery, University of Heidelberg, Heidelberg, Germany;

关键词: SEER Program;    low-grade glioma;    incidence;    risk factor;    molecular marker;   

DOI  :  10.3389/fonc.2023.1079597

 received in 2022-10-25, accepted in 2023-02-13,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundUnderstanding the epidemiology and prognostic factors of low-grade gliomas (LGGs) can help estimate the public health impact and optimize risk stratification and treatment strategies.Methods3 337 patients diagnosed with LGGs were collected from the Surveillance, Epidemiology, and End Results (SEER) dataset, 2004–2019. The incidence trends of LGGs were analyzed by patient demographics (sex, age, race, and ethnicity). In addition, a competing risk regression model was used to explore the prognostic factors of LGGs by patient demographics, tumor characteristics (histological subtypes, invasiveness, and size), treatment modality, and molecular markers (IDH mutation and 1p/19q codeletion).ResultsLGGs occurred more frequently in male, non-Hispanic, and White populations. The incidence rate of mixed gliomas was stable from 2004 to 2013 and decreased dramatically to nearly zero until 2019. The risk of death increased 1.99 times for every 20-year increase in patient age, and 60 years is a predictive cut-off age for risk stratification of LGGs. Male patients showed poorer LGG-specific survival. Among the different subtypes, astrocytoma has the worst prognosis, followed by mixed glioma and oligodendroglioma. Tumors with larger size (≥5 cm) and invasive behavior tended to have poorer survival. Patients who underwent gross total resection had better survival rates than those who underwent subtotal resection. Among the different treatment modalities, surgery alone had the best survival, followed by surgery + radiotherapy + chemotherapy, but chemotherapy alone had a higher death risk than no treatment. Furthermore, age, invasiveness, and molecular markers were the most robust prognostic factors.ConclusionThis study reviewed the incidence trends and identified several prognostic factors that help clinicians identify high-risk patients and determine the need for postoperative treatment according to guidelines.

【 授权许可】

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Copyright © 2023 Cao, Yan, Zhan, Hong and Yan