Published in:
01-12-2018 | Clinical Study
A comparative analysis of clinicopathological features and survival among early adolescents/young adults and children with low-grade glioma: a report from the Children’s Oncology Group
Published in: Journal of Neuro-Oncology | Issue 3/2018
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Background
For several types of cancer, biological differences and outcome disparities have been documented in adolescents/young adults (AYAs, 15–39 years old) versus children. This study compared clinicopathological features and survival between younger AYAs and children with low-grade glioma (LGG), a common brain tumor among AYAs.
Methods
This was a secondary analysis of Children’s Oncology Group legacy study CCG-9891/POG-9130, which enrolled participants 0–21 years of age with newly-diagnosed LGG treated with surgery alone. For analysis, participants were categorized as children (0–14 years old) or early AYAs (eAYAs, 15–21 years old) and compared on demographics, clinical presentation, tumor characteristics, surgical outcomes, progression-free survival (PFS) and overall survival (OS).
Results
Among 468 children and 50 eAYAs, more eAYAs presented with seizures (34.0% vs. 19.2%; p = 0.015), without other significant differences in clinicopathological features. 5-year PFS rates for children and eAYA were 80.2% (95% confidence interval [95% CI], 76.1–83.7) and 83.0% (95% CI 68.8–91.1), respectively; 5-year OS rates were 97.3% (95% CI 95.2–98.5) and 95.4% (95% CI 82.7–98.8), respectively. Multivariable analysis including all participants showed presence of residual tumor to be an independent predictor of PFS (< 1.5 cm3, hazard ratio [HR] 5.93 [95% CI 3.45–10.18]) and (≥ 1.5 cm3, HR 8.38 [95% CI 4.75–14.79]) (p < 0.001), while midline-chiasmatic location (HR 9.69 [95% CI 3.05–30.75], p < 0.001) and non-pilocytic astrocytoma histology (HR 6.77 [95% CI 2.35–19.49], p < 0.001) were independent predictors of OS.
Conclusion
Unlike several other cancers, LGG has similar presenting features and survival for both eAYAs and children. This support continuing a unified treatment approach and enrollment of eAYAs in pediatric clinical trials for LGGs.