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BMC Neurology

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Open Access 01-12-2022 | Glioblastoma | Research

Exploring the relationship between age and prognosis in glioma: rethinking current age stratification

Authors: Zetian Jia, Xiaohui Li, Yaqi Yan, Xuxuan Shen, Jiuxin Wang, He Yang, Shuo Liu, Chengxi Han, Yuhua Hu

Published in: BMC Neurology | Issue 1/2022

Abstract

Background

The age of glioma plays a unique role in prognosis. We hypothesized that age is not positively correlated with survival prognosis and explored its exact relationship.

Methods

Glioma was identified from the SEER database (between 2000 and 2018). A multivariate Cox proportional regression model and restricted cubic spline (RCS) plot were used to assess the relationship between age and prognosis.

Results

A total of 66465 patients with glioma were included. Hazard ratios (HR) for ten-year by age: 0–9 years, HR 1.06 (0.93–1.20); 10–19 years: reference; 20–29 years, HR 0.90 (0.82–1.00); 30–39 years, HR 1.14 (1.04–1.25); 40–49 years, HR 2.09 (1.91–2.28); 50–59 years, HR 3.48 (3.19–3.79); 60–69 years, HR 4.91 (4.51–5.35);70–79 years, HR 7.95 (7.29–8.66); 80–84 years, HR 12.85 (11.74–14.06). After adjusting for covariates, the prognosis was not positively correlated with age. The smooth curve of RCS revealed this non-linear relationship: HR increased to 10 years first, decreased to 23 years, reached its lowest point, and became J-shaped.

Conclusion

The relationship between age and glioma prognosis is non-linear. These results challenge the applicability of current age groupings for gliomas and advocate the consideration of individualized treatment guided by precise age.

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Weller M, Wick W, Aldape K, Brada M, Berger M, Pfister SM, et al. Glioma. Nat Rev Dis Primers. 2015;1:15017. https://doi.org/10.1038/nrdp.2015.17.CrossRefPubMed

Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer Statistics, 2021. CA Cancer J Clin. 2021;71(1):7–33. https://doi.org/10.3322/caac.21654.CrossRefPubMed

Tan AC, Ashley DM, López GY, Malinzak M, Friedman HS, Khasraw M. Management of glioblastoma: State of the art and future directions. CA Cancer J Clin. 2020;70(4):299–312. https://doi.org/10.3322/caac.21613.CrossRefPubMed

Weller M, Le Rhun E. How did lomustine become standard of care in recurrent glioblastoma? Cancer Treat Rev. 2020;87:102029. https://doi.org/10.1016/j.ctrv.2020.102029.CrossRefPubMed

Davis FG, Freels S, Grutsch J, Barlas S, Brem S. Survival rates in patients with primary malignant brain tumors stratified by patient age and tumor histological type: an analysis based on Surveillance, Epidemiology, and End Results (SEER) data, 1973-1991. J Neurosurg. 1998;88(1):1–10. https://doi.org/10.3171/jns.1998.88.1.0001.CrossRefPubMed

Yang LS, Huang FP, Zheng K, Zhang HS, Zhou X, Bao XH, et al. Factors affecting prognosis of patients with intracranial anaplastic oligodendrogliomas: a single institutional review of 70 patients. J Neurooncol. 2010;100(1):113–20. https://doi.org/10.1007/s11060-010-0146-4.CrossRefPubMed

Weller M, van den Bent M, Tonn JC, Stupp R, Preusser M, Cohen-Jonathan-Moyal E, et al. European Association for Neuro-Oncology (EANO) guideline on the diagnosis and treatment of adult astrocytic and oligodendroglial gliomas. Lancet Oncol. 2017;18(6):e315–e29. https://doi.org/10.1016/s1470-2045(17)30194-8.CrossRefPubMed

Allahdini F, Amirjamshidi A, Reza-Zarei M, Abdollahi M. Evaluating the prognostic factors effective on the outcome of patients with glioblastoma multiformis: does maximal resection of the tumor lengthen the median survival? World Neurosurg. 2010;73(2):128–34; discussion e16;. https://doi.org/10.1016/j.wneu.2009.06.001.CrossRefPubMed

Jia Z, Yan Y, Wang J, Yang H, Zhan H, Chen Q, et al. Development and validation of prognostic nomogram in ependymoma: A retrospective analysis of the SEER database. Cancer Med. 2021;10(17):6140–8. https://doi.org/10.1002/cam4.4151.CrossRefPubMedPubMedCentral

10.

Lin Z, Yang R, Li K, Yi G, Li Z, Guo J, et al. Establishment of age group classification for risk stratification in glioma patients. BMC Neurol. 2020;20:1:310. https://doi.org/10.1186/s12883-020-01888-w.CrossRef

11.

Gritsch S, Batchelor TT, Gonzalez Castro LN. Diagnostic, therapeutic, and prognostic implications of the 2021 World Health Organization classification of tumors of the central nervous system. Cancer. 2022;128(1):47–58. https://doi.org/10.1002/cncr.33918.CrossRefPubMed

12.

Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016;131(6):803–20. https://doi.org/10.1007/s00401-016-1545-1.CrossRefPubMed

13.

Clarke MA, Devesa SS, Harvey SV, Wentzensen N. Hysterectomy-Corrected Uterine Corpus Cancer Incidence Trends and Differences in Relative Survival Reveal Racial Disparities and Rising Rates of Nonendometrioid Cancers. J Clin Oncol. 2019;37(22):1895–908. https://doi.org/10.1200/jco.19.00151.CrossRefPubMedPubMedCentral

14.

Chandra A, Lopez-Rivera V, Dono A, Brandel MG, Lewis C, O'Connor KP, et al. Comparative Analysis of Survival Outcomes and Prognostic Factors of Supratentorial versus Cerebellar Glioblastoma in the Elderly: Does Location Really Matter? World Neurosurg. 2021;146:e755–e67. https://doi.org/10.1016/j.wneu.2020.11.003.CrossRefPubMed

15.

Miller KD, Ostrom QT, Kruchko C, Patil N, Tihan T, Cioffi G, et al. Brain and other central nervous system tumor statistics, 2021. CA Cancer J Clin. 2021;71(5):381–406. https://doi.org/10.3322/caac.21693.CrossRefPubMed

16.

Smoll NR, Gautschi OP, Schatlo B, Schaller K, Weber DC. Relative survival of patients with supratentorial low-grade gliomas. Neuro-oncology. 2012;14(8):1062–9. https://doi.org/10.1093/neuonc/nos144.CrossRefPubMedPubMedCentral

17.

Durrleman S, Simon R. Flexible regression models with cubic splines. Stat Med. 1989;8(5):551–61. https://doi.org/10.1002/sim.4780080504.CrossRefPubMed

18.

Chen JW, Zhou CF, Lin ZX. The influence of different classification standards of age groups on prognosis in high-grade hemispheric glioma patients. J Neurol Sci. 2015;356(1-2):148–52. https://doi.org/10.1016/j.jns.2015.06.036.CrossRefPubMed

19.

Adam MA, Thomas S, Hyslop T, Scheri RP, Roman SA, Sosa JA. Exploring the Relationship Between Patient Age and Cancer-Specific Survival in Papillary Thyroid Cancer: Rethinking Current Staging Systems. J Clin Oncol. 2016;34(36):4415–20. https://doi.org/10.1200/JCO.2016.68.9372.CrossRefPubMedPubMedCentral

20.

Nghiemphu PL, Liu W, Lee Y, Than T, Graham C, Lai A, et al. Bevacizumab and chemotherapy for recurrent glioblastoma: a single-institution experience. Neurology. 2009;72(14):1217–22. https://doi.org/10.1212/01.wnl.0000345668.03039.90.CrossRefPubMedPubMedCentral

21.

Batchelor TT, Betensky RA, Esposito JM, Pham LD, Dorfman MV, Piscatelli N, et al. Age-dependent prognostic effects of genetic alterations in glioblastoma. Clinical Cancer Res. 2004;10(1 Pt 1):228–33. https://doi.org/10.1158/1078-0432.ccr-0841-3.CrossRef

22.

Schwartzentruber J, Korshunov A, Liu XY, Jones DT, Pfaff E, Jacob K, et al. Driver mutations in histone H3.3 and chromatin remodelling genes in paediatric glioblastoma. Nature. 2012;482(7384):226–31. https://doi.org/10.1038/nature10833.CrossRefPubMed

23.

Zhao F, Zhang J, Li P, Zhou Q, Zhang S, Zhao C, et al. Prognostic value of Ki-67 index in adult medulloblastoma after accounting for molecular subgroup: a retrospective clinical and molecular analysis. J Neurooncol. 2018;139(2):333–40. https://doi.org/10.1007/s11060-018-2865-x.CrossRefPubMed

24.

Yan H, Parsons DW, Jin G, McLendon R, Rasheed BA, Yuan W, et al. IDH1 and IDH2 mutations in gliomas. N Engl J Med. 2009;360(8):765–73. https://doi.org/10.1056/NEJMoa0808710.CrossRefPubMedPubMedCentral

25.

Wu F, Zhang C, Zhao C, Wu H, Teng Z, Jiang T, et al. Prostaglandin E1 Inhibits GLI2 Amplification-Associated Activation of the Hedgehog Pathway and Drug Refractory Tumor Growth. Cancer Res. 2020;80(13):2818–32. https://doi.org/10.1158/0008-5472.Can-19-2052.CrossRefPubMed

26.

Krigers A, Demetz M, Thome C, Freyschlag CF. Age is associated with unfavorable neuropathological and radiological features and poor outcome in patients with WHO grade 2 and 3 gliomas. Sci Rep. 2021;11(1):17380. https://doi.org/10.1038/s41598-021-96832-4.CrossRefPubMedPubMedCentral

Title: Exploring the relationship between age and prognosis in glioma: rethinking current age stratification
Authors: Zetian Jia
Xiaohui Li
Yaqi Yan
Xuxuan Shen
Jiuxin Wang
He Yang
Shuo Liu
Chengxi Han
Yuhua Hu
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Glioblastoma
Astrocytoma
Glioma
Glioma
Astrocytoma
Glioblastoma
Astrocytoma
Glioblastoma
Glioma
Published in: BMC Neurology / Issue 1/2022
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-022-02879-9

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Exploring the relationship between age and prognosis in glioma: rethinking current age stratification

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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