Causes of death in pediatric neuro-oncology: the sickkids experience from 2000 to 2017
- 1 August 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Neuro-Oncology
- Vol. 149 (1), 181-189
- https://doi.org/10.1007/s11060-020-03590-w
Abstract
Purpose Primary benign and malignant central nervous system (CNS) tumors are the most frequent solid tumors in the pediatric age and represent the leading cause of death by cancer in children in high income countries. However, information regarding specific causes of death in this population is still limited. The objective of this work was to investigate mortality in a large cohort of children diagnosed at our institution. Methods We identified patients consecutively diagnosed with CNS tumor and treated at a Tertiary Care Canadian Children's Hospital between January 2000 and December 2017. Patient charts were reviewed and different variables such as tumor diagnosis, location, gender, age at diagnosis, age at death and cause of death collected. Results Of 1274 patients, 306 (24%) succumbed to their disease. Mortality rate varied significantly according to tumor subtype, ranging from 3.1% in low grade glioma (LGG) to 97.8% in diffuse intrinsic pontine glioma (DIPG). While high grade gliomas (HGG) and DIPG represented only 6.3 and 7.1% of total diagnoses respectively, together they accounted for 49.3% of total deaths (n = 151). Median time from diagnosis to death was 15 months (4 days to 15 years) and shortest for DIPG (11 months). Two hundred and ninety patients (94.8%) died as a result of the primary disease, 4 of treatment-related toxicity, two patients' deaths were unrelated to the primary disease (idiopathic encephalopathy and domestic fire) whereas 10 patients succumbed to a secondary malignancy. Of note, four of these ten patients had a confirmed underlying cancer predisposition syndrome. Conclusion Disease progression is the main cause of death in children with brain tumor, while treatment related mortality is low in this series. Research should continue to focus on improving treatment strategies for patients whose prognosis remains dismal.This publication has 37 references indexed in Scilit:
- Cancer statistics, 2013CA: A Cancer Journal for Clinicians, 2013
- Survival and secondary tumors in children with medulloblastoma receiving radiotherapy and adjuvant chemotherapy: results of Children's Oncology Group trial A9961Neuro-Oncology, 2012
- Pediatric neuro-oncology: Current status and future directionsAsia-Pacific Journal of Clinical Oncology, 2012
- Epidemiology of childhood cancerCancer Treatment Reviews, 2010
- The Austrian Brain Tumour Registry: a cooperative way to establish a population-based brain tumour registryJournal of Neuro-Oncology, 2009
- Trends in childhood cancer incidence in the U.S. (1992–2004)Cancer, 2007
- Clinical and Molecular Characteristics of Malignant Transformation of Low-Grade Glioma in ChildrenJournal of Clinical Oncology, 2007
- Late sequela after treatment of childhood low-grade gliomas: a retrospective analysis of 69 long-term survivors treated between 1983 and 2003Journal of Neuro-Oncology, 2006
- Epidemiology of brain tumors in childhood—a reviewToxicology and Applied Pharmacology, 2004
- On dispersion in tracer experimentsJournal of Theoretical Biology, 1973