The Role of Time as a Prognostic Factor in Pediatric Brain Tumors: a Multivariate Survival Analysis
- PDF / 330,376 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 49 Downloads / 185 Views
ORIGINAL ARTICLE
The Role of Time as a Prognostic Factor in Pediatric Brain Tumors: a Multivariate Survival Analysis Eduardo Javier Barragán-Pérez 1 & Carlos Enrique Altamirano-Vergara 1 & Daniel Eduardo Alvarez-Amado 1,2 & Juan Carlos García-Beristain 1 & Fernando Chico-Ponce-de-León 3 & Vicente González-Carranza 3 & Luis Juárez-Villegas 4 & Chiharu Murata 5 Received: 27 March 2020 / Accepted: 9 July 2020 # Arányi Lajos Foundation 2020
Abstract There is no evidence that prolonged pre diagnostic symptomatic intervals (PSI) increases the risk of death in pediatric brain tumors. When investigating the role of time previous research had not controlled for confounding variables or measured the pretreatment interval (PTI). We use the term global delay interval (GDI) to describe the sum of PSI and PTI. The aim of this research was to evaluate whether there was a decrease in the probability of survival in children with brain tumors due to a prolonged PSI, PTI and GDI, using a multivariate survival analysis. We retrospective review 127 clinical records labeled with the diagnosis of CNS tumors attended at a specialized pediatric center in Mexico City from January 2008 to December 2012. Patients with PSI and GDI diagnosed between 3 and 6 months showed statistical lower probability of surviving that those with intervals 0.05.
High grade tumors accounted for 47.2% (n = 60) of the total sample and 52.3% (n = 67) were low grade tumors. A detailed summary of the main tumors can be found in the Supporting Information Table S2. The total pre symptomatic interval median was 90 days (IQR: 60, 180; Max-Min: 5–1440) and 13 days (IQR: 10, 20; Max-Min: 1–200) for the pretreatment interval. When we took into account both, we got a median global delay interval of 120 days (IQR: 68, 190; Max-Min: 15–1500). The median PSI for low grade tumors was 120 days (IQR: 60, 180) and for high grade tumors 90 days (52.5, 150). PTI has a median of 13 days (IQR: 10, 18) for low grade tumors and 14 days (10, 20) for high grade tumors. Median GDI was 128 (IQR: 68, 198) and 115 days (60.5, 170) respectively.
Survival Analysis The Kaplan-Meier Curve with their respective survival table for the main categories are shown in Fig. 1. At five years, the overall survival (OS) was 70% (n = 127; 95% confidence interval, CI = 0.63–0.79). The shortest median survival time observed was 5.5 months (IQR: 3.5–19.5) for patients with Embryonal Tumor with Rhabdoid Feature followed by Diffuse Midline Glioma with 7 months (IQR: 5.0–8.5). The five year OS for patients with low grade tumors was 88% (n = 67, OS = 0.88; CI = 0.80–0.96) and 50% for those with high grade tumors
Results Demographic and Clinical Characteristics Demographic and clinical characteristics of the patients can be seen in Table 1. The median age at diagnosis was 5 years (IQR: 3–8) with 68 males (53.5%) and 59 females (46.5%).
a
b
Survival curves for the main categories of brain tumors Based on Kaplan−Meier estimates 1.00
+ +
+ +
+ +
+ + +
+ + +
+ + +
+ +
+ +
+ +
+ +
+
+
+ +
Survival cu
Data Loading...
