Characterization and outcomes of infratentorial malignant glioma: a population-based study using the Surveillance Epidemiology and End-Results database.

Abstract

Using a population-based database, we sought to characterize brainstem gliomas and to evaluate the prognosis of various subgroups. Using the Surveillance Epidemiology and End-Results (SEER) database we identified patients diagnosed with malignant infratentorial gliomas between 1988 and 2003 who underwent a surgical procedure and/or received radiation therapy (RT). A total of 455 patients were identified with a median age at diagnosis of 13 years (range 0-87). The overwhelming majority, 95.6%, received RT. Median survival (MS) was 11 months. Those not undergoing RT had a MS of 3 months. MS varied significantly by age, p<0.001. MS for patients aged 0-18 years was 11 months; 19-29 years was 35 months; 30-49 years was 17 months; 50-69 years was 6 months; and 70 years or older was 3 months. The small group with grades I and II tumors had improved MS of 58 and 37 months, respectively. There was no difference in survival by the year of diagnosis (1999 versus 2000 or later) with MS of 10 versus 11 months, respectively, p=0.949. Brainstem glioma is primarily a childhood malignancy with a generally poor prognosis. A minority of patients has favorable features and can achieve long-term survival.