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Depond CC, Zouaoui S, Darlix A, Rigau V, Mathieu-Daudé H, Bauchet F, Khettab M, Trétarre B, Figarella-Branger D, Taillandier L, Boetto J, Pallud J, Zemmoura I, Roche PH, Bauchet L. Descriptive epidemiology of 30,223 histopathologically confirmed meningiomas in France: 2006-2015. Acta Neurochir (Wien) 2024; 166:214. [PMID: 38740641 DOI: 10.1007/s00701-024-06093-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/13/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND AND OBJECTIVES Meningioma is one of the most common neoplasm of the central nervous system. To describe the epidemiology of meningioma operated in France and, to assess grading and histopathological variability among the different neurosurgical centres. METHODS We processed the French Brain Tumour Database (FBTDB) to conduct a nationwide population-based study of all histopathologically confirmed meningiomas between 2006 and 2015. RESULTS 30,223 meningiomas cases were operated on 28,424 patients, in 61 centres. The average number of meningioma operated per year in France was 3,022 (SD ± 122). Meningioma was 3 times more common in women (74.1% vs. 25.9%). The incidence of meningioma increased with age and, mean age at surgery was 58.5 ± 13.9 years. Grade 1, 2, and 3 meningiomas accounted for 83.9%, 13.91% and, 2.19% respectively. There was a significant variability of meningioma grading by institutions, especially for grade 2 which spanned from 5.1% up to 22.4% (p < 0.001). Moreover, the proportion of grade 2 significantly grew over the study period (p < 0.001). There was also a significant variation in grade 1 subtypes diagnosis among the institutions (p < 0.001). 89.05% of the patients had solely one meningioma surgery, 8.52% two and, 2.43% three or more. The number of surgeries was associated to the grade of malignancy (p < 0.001). CONCLUSION The incidence of meningioma surgery increased with age and, peaked at 58.5 years. They were predominantly benign with meningothelial subtype being the most common. However, there was a significant variation of grade 1 subtypes diagnosis among the centres involved. The proportion of grade 2 meningioma significantly grew over the study time, on contrary to malignant meningioma proportion, which remained rare and, stable over time around 2%. Likewise, there was a significant variability of grade 2 meningioma rate among the institutions.
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Affiliation(s)
- Charles Champeaux Depond
- Department of Neurosurgery, Hôpital Privé Clairval - Ramsay Santé, 317 Bd de Redon, 13009, Marseille, France.
| | - Sonia Zouaoui
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier cedex 5, France
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
| | - Amélie Darlix
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- Medical Oncology Department, Institut du Cancer de Montpellier, University of Montpellier, 34298, Montpellier, France
| | - Valérie Rigau
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- Department of Pathology, Gui-de-Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier cedex 5, France
| | - Hélène Mathieu-Daudé
- Department of Epidemiology, French Brain Tumour Database, GNOLR, Registre Des Tumeurs de L'Hérault, ICM, 34298, Montpellier cedex 5, France
| | - Fabienne Bauchet
- Department of Epidemiology, French Brain Tumour Database, GNOLR, Registre Des Tumeurs de L'Hérault, ICM, 34298, Montpellier cedex 5, France
| | - Mohamed Khettab
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- Medical Oncology Unit, CHU de La Réunion, Université de La Réunion, 97410, Saint Pierre, France
| | - Brigitte Trétarre
- Registre Des Tumeurs de L'Hérault, ICM, 34298, Montpellier cedex 5, France
| | - Dominique Figarella-Branger
- Institut de Neurophysiopathologie, Service d'Anatomie Pathologique Et de Neuropathologie, Aix-Marseille University, APHM, CNRS, INP, CHU Timone, 13005, Marseille, France
| | - Luc Taillandier
- Department of Neurology, University Hospital of Nancy, Nancy, France
| | - Julien Boetto
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier cedex 5, France
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
- Paris Brain Institute, Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, 75013, Paris, France
| | - Johan Pallud
- Service de Neurochirurgie, GHU Paris Psychiatrie Et Neurosciences, Site Sainte Anne, 75014, Paris, France
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris, INSERM U1266, 75014, Paris, France
| | - Ilyess Zemmoura
- Neurosurgery Department, CHRU de Tours, Tours, France
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Pierre-Hugues Roche
- Neurosurgery Department, CHRU de Tours, Tours, France
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
- Service de Neurochirurgie de L'hôpital Nord, APHM - AMU, Marseille, France
| | - Luc Bauchet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295, Montpellier cedex 5, France
- Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, 34094, Montpellier, France
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Sekely A, Zakzanis KK, Mabbott D, Tsang DS, Kongkham P, Zadeh G, Edelstein K. Long-term neurocognitive and psychological outcomes in meningioma survivors: Individual changes over time and radiation dosimetry. Neurooncol Pract 2024; 11:157-170. [PMID: 38496914 PMCID: PMC10940838 DOI: 10.1093/nop/npad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024] Open
Abstract
Background This study investigates long-term changes in neurocognitive performance and psychological symptoms in meningioma survivors and associations with radiation dose to circumscribed brain regions. Methods We undertook a retrospective study of meningioma survivors who underwent longitudinal clinical neurocognitive assessments. Change in neurocognitive performance or psychological symptoms was assessed using reliable change indices. Radiation dosimetry, if prescribed, was evaluated based on treatment-planning computerized tomography co-registered with contrast-enhanced 3D T1-weighted magnetic resonance imaging. Mixed effects analyses were used to explore whether incidental radiation to brain regions outside the tumor influences neurocognitive and psychological outcomes. Results Most (range = 41%-93%) survivors demonstrated stable-albeit often below average-neurocognitive and psychological trajectories, although some also exhibited improvements (range = 0%-31%) or declines (range = 0%-36%) over time. Higher radiation dose to the parietal-occipital region (partial R2 = 0.462) and cerebellum (partial R2 = 0.276) was independently associated with slower visuomotor processing speed. Higher dose to the hippocampi was associated with increases in depression (partial R2 = 0.367) and trait anxiety (partial R2 = 0.236). Conclusions Meningioma survivors experience neurocognitive deficits and psychological symptoms many years after diagnosis, and a proportion of them decline over time. This study offers proof of concept that incidental radiation to brain regions beyond the tumor site may contribute to these sequelae. Future investigations should include radiation dosimetry when examining risk factors that contribute to the quality of survivorship in this growing population.
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Affiliation(s)
- Angela Sekely
- Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Konstantine K Zakzanis
- Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Donald Mabbott
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychology, Neurosciences, and Mental Health Program, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Derek S Tsang
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Paul Kongkham
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Gelareh Zadeh
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Kim Edelstein
- Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Feigl GC, Staribacher D, Britz G, Kuzmin D. Minimally Invasive Approaches in the Surgical Treatment of Intracranial Meningiomas: An Analysis of 54 Cases. Brain Tumor Res Treat 2024; 12:93-99. [PMID: 38742257 PMCID: PMC11096627 DOI: 10.14791/btrt.2024.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/01/2024] [Accepted: 03/08/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Intracranial meningiomas, being a fairly common disease in the population, often require surgical treatment, which, in turn, can completely heal the patient. The localization of meningiomas often influences treatment even if they are asymptomatic. By modernizing approaches to surgical treatment, it is possible to minimize intra- and postoperative risks, while achieving complete removal of the tumor. One of these methods is minimally invasive neurosurgery, the development of which in recent years allows it to compete with standard surgical methods. The purpose of this study was the objectification of minimally invasive approaches, such as the calculation of the craniotomy area and the ratio of craniotomy area to the resected tumor volume. METHODS The retrospective study consisted of a group of 54 consecutive patients who were operated on in our neurosurgery clinic specialized on minimally invasive neurosurgery. Preoperative planning was carried out using the Surgical Theater visualization platform. Using this system, the tumor volume and craniotomy surface area were calculated. During the analysis, the symptoms before and after the surgery, classification of tumors, postoperative complications, further treatment and follow-up results were assessed. RESULTS Twelve (22.2%) patients were men and 42 (77.8%) were women. The mean age of the group was 64.2 years (median 67.5). The craniotomy area ranged from 202 to 2,108 mm² (mean 631 mm²). Tumor volume ranged from 0.85 to 110.1 cm3 (mean 21.6 cm3). The craniotomy size of minimally invasive approaches to the skull base was 3-5 times smaller than standard approaches. Skull base meningiomas accounted for 19 cases (35.2%), convexity meningiomas for 26 cases (48.1%), and falx and tentorium meningiomas for 9 cases (16.7%). Three complications were reported: postoperative hemorrhage, CSF leakage, and ophthalmoplegia. Relapse was detected in 2 patients with a mean follow-up of 26.3 months (median 20). CONCLUSION Minimally invasive approaches in the surgical treatment of intracranial meningiomas reduce the possibility of operating trauma by several times; they are safe and sufficient for complete removal of the tumor.
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Affiliation(s)
- Guenther C Feigl
- General Hospital Bamberg, Bamberg, Germany
- University Hospital Tuebingen, Tuebingen, Germany
- Houston Methodist Hospital, Houston, Texas, USA.
| | | | - Gavin Britz
- Houston Methodist Hospital, Houston, Texas, USA
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Toader C, Dobrin N, Tataru CI, Covache-Busuioc RA, Bratu BG, Glavan LA, Costin HP, Corlatescu AD, Dumitrascu DI, Ciurea AV. From Genes to Therapy: Pituitary Adenomas in the Era of Precision Medicine. Biomedicines 2023; 12:23. [PMID: 38275385 PMCID: PMC10813694 DOI: 10.3390/biomedicines12010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
This review presents a comprehensive analysis of pituitary adenomas, a type of brain tumor with diverse behaviors and complexities. We cover various treatment approaches, including surgery, radiotherapy, chemotherapy, and their integration with newer treatments. Key to the discussion is the role of biomarkers in oncology for risk assessment, diagnosis, prognosis, and the monitoring of pituitary adenomas. We highlight advances in genomic, epigenomic, and transcriptomic analyses and their contributions to understanding the pathogenesis and molecular pathology of these tumors. Special attention is given to the molecular mechanisms, including the impact of epigenetic factors like histone modifications, DNA methylation, and transcriptomic changes on different subtypes of pituitary adenomas. The importance of the tumor immune microenvironment in tumor behavior and treatment response is thoroughly analyzed. We highlight potential breakthroughs and innovations for a more effective management and treatment of pituitary adenomas, while shedding light on the ongoing need for research and development in this field to translate scientific knowledge into clinical advancements, aiming to improve patient outcomes.
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Affiliation(s)
- Corneliu Toader
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (D.-I.D.); (A.V.C.)
- Department of Vascular Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 077160 Bucharest, Romania
| | - Nicolaie Dobrin
- Neurosurgical Clinic, “Prof. Dr. N. Oblu” Emergency Clinical Hospital, 700309 Iași, Romania
| | - Catalina-Ioana Tataru
- Department of Ophthalmology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Ophthalmology, Clinical Hospital of Ophthalmological Emergencies, 010464 Bucharest, Romania
| | - Razvan-Adrian Covache-Busuioc
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (D.-I.D.); (A.V.C.)
| | - Bogdan-Gabriel Bratu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (D.-I.D.); (A.V.C.)
| | - Luca Andrei Glavan
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (D.-I.D.); (A.V.C.)
| | - Horia Petre Costin
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (D.-I.D.); (A.V.C.)
| | - Antonio Daniel Corlatescu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (D.-I.D.); (A.V.C.)
| | - David-Ioan Dumitrascu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (D.-I.D.); (A.V.C.)
- Neurosurgery Department, Sanador Clinical Hospital, 010991 Bucharest, Romania
| | - Alexandru Vlad Ciurea
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (D.-I.D.); (A.V.C.)
- Neurosurgery Department, Sanador Clinical Hospital, 010991 Bucharest, Romania
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Ullah S, Qureshi AZ, Rathore FA, Sami W, Moukais IS, Alibrahim FS, Asiri IA, Alsuhaibani A. Functional Outcomes of Patients with Primary Brain Tumors Undergoing Inpatient Rehabilitation at a Tertiary Care Rehabilitation Facility in Saudi Arabia. Int J Environ Res Public Health 2023; 20:4679. [PMID: 36981589 PMCID: PMC10049031 DOI: 10.3390/ijerph20064679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/28/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
Rehabilitation services play a crucial role in improving the functionality and quality of life of individuals with a brain tumor; however, outcomes of inpatient rehabilitation based on tumor characteristics are not well known in the literature. This study was carried out to evaluate the effects of tumor characteristics on functional outcomes. A retrospective chart review was conducted for all adults with a diagnosis of primary brain tumor admitted for IPR between January 2014 and December 2019. Information was collected regarding demographics, characteristics of primary brain tumors, length of stay (LOS) and Functional Independence Measurement (FIM) scores. There were 46 patients, with the majority being male. The most common brain tumors were glioblastoma multiforme and meningioma. The mean LOS was 47.93 ± 26.40 days and the mean FIM gain was 78 ± 14. The type, grade and location of primary brain tumors did not show a significant correlation with the length of stay and functional gains during inpatient rehabilitation. There was a positive correlation between the FIM at admission and discharge, and a significant inverse correlation between the FIM score at admission and LOS. In-patient rehabilitation improved the functional outcomes in adult patients with primary brain tumors. Strategies to incorporate IPR in the care continuum of patients with brain tumors need to be adapted to improve regional services.
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Affiliation(s)
- Sami Ullah
- Department of Physical Medicine and Rehabilitation, King Fahad Medical City, Riyadh 11525, Saudi Arabia
- Department of Physical Medicine and Rehabilitation, Qatar Rehabilitation Institute, Doha P.O. Box 3050, Qatar
| | - Ahmad Zaheer Qureshi
- Department of Physical Medicine and Rehabilitation, King Fahad Medical City, Riyadh 11525, Saudi Arabia
| | - Farooq Azam Rathore
- Department of Rehabilitation Medicine, PNS Shifa Hospital, Karachi 75530, Pakistan
| | - Waqas Sami
- College of Nursing, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Imad Saeed Moukais
- Department of Physical Medicine and Rehabilitation, King Fahad Medical City, Riyadh 11525, Saudi Arabia
| | - Fatimah Saif Alibrahim
- Department of Orthopedics, King Saud University Medical City, Riyadh 12372, Saudi Arabia
| | - Ibrahim Ali Asiri
- Department of Physical Medicine and Rehabilitation, King Fahad Medical City, Riyadh 11525, Saudi Arabia
| | - Ayman Alsuhaibani
- Department of Physical Medicine and Rehabilitation, King Fahad Medical City, Riyadh 11525, Saudi Arabia
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Champeaux-Depond C, Constantinou P, Tuppin P, Resche-Rigon M, Weller J. Relative survival after meningioma surgery. A French nationwide population-based cohort study. Br J Neurosurg 2022:1-7. [PMID: 36576058 DOI: 10.1080/02688697.2022.2159925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 10/31/2022] [Accepted: 12/13/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Survival after meningioma surgery is often reported with inadequate allowance for competing causes of death. METHODS We processed the Système National des Données de Santé, the French administrative medical database to retrieve appropriate patients' case of surgically treated meningiomas. The Pohar Perme relative survival (RS) method was implement. RESULTS A total of 28,778 patients were identified between 2007 and 2017 of which 75% were female. Median age at surgery 59 years. Cranial convexity was the most common (24.7%) location and, benign meningioma represented 91.5% of all meningioma. Median follow-up was 3.5 years interquartile range [3.4-3.5]. At data collection, 2,232 patients were dead. The five-year survival relative to the expected survival of an age- and gender-matched French standard population was 96.2% 95% confidence interval (CI)[95.7-96.8]. Meningioma absolute excess risk of death was 973/100,000 person-years 95%CI[887-1068] (p< .001). The related standardised mortality ratio was 1.8 95%CI[1.7-1.9] (p< .001). In the adjusted model, male gender (hazard ratio [HR] =1.39, 95%CI[1.27-1.54], p< .001), age at surgery (HR=0.97, 95%CI[0.97-0.97], p < .001), type 2 neurofibromatosis (HR=2.95, 95%CI[1.95-4.46], p < .001), comorbidities HR=1.39, 95%CI[1.36-1.42], p < .001), location (HR=0.8, 95%CI[0.67-0.95], p= .0111), pre-operative embolization, (HR=1.3, 95%CI[1.08-1.56], p= .00507), cerebro-spinal fluid shunt, (HR=2.48, 95%CI[2.04-3.01], p < .001), atypical (HR=1.3, 95%CI [1.09-1.54], p= .00307) or malignant histology (HR=1.86, 95%CI[1.56-2.22], p< .001), redo surgery (HR=1.19, 95%CI[1.04-1.36], p= .0122) and radiotherapy (HR=1.43, 95%CI[1.26-1.62], p < .001) were established as independent predictors of RS. CONCLUSION This unique study highlights the excess mortality associated with meningioma disease. Many factors such as gender, age, location, histopathological grading, redo surgery influence the RS.
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Affiliation(s)
- Charles Champeaux-Depond
- Department of Neurosurgery, Lariboisière Hospital, Paris, France
- INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), ECSTRRA Team, Université de Paris, Paris, France
| | | | | | - Matthieu Resche-Rigon
- INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), ECSTRRA Team, Université de Paris, Paris, France
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Gately L, Drummond K, Rosenthal M, Harrup R, Dowling A, Gogos A, Lwin Z, Collins I, Campbell D, Ahern E, Phillips C, Gan HK, Bennett I, Sieber OM, Gibbs P. Beyond standard data collection – the promise and potential of BRAIN (Brain tumour Registry Australia INnovation and translation registry). BMC Cancer 2022; 22:604. [PMID: 35655179 PMCID: PMC9161524 DOI: 10.1186/s12885-022-09700-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Real-world data (RWD) is increasingly being embraced as an invaluable source of information to address clinical and policy-relevant questions that are unlikely to ever be answered by clinical trials. However, the largely unrealised potential of RWD is the value to be gained by supporting prospective studies and translational research. Here we describe the design and implementation of an Australian brain cancer registry, BRAIN, which is pursuing these opportunities.
Methods
BRAIN was designed by a panel of clinicians in conjunction with BIOGRID to capture comprehensive clinical data on patients diagnosed with brain tumours from diagnosis through treatment to recurrence or death. Extensive internal and external testing was undertaken, followed by implementation at multiple sites across Victoria and Tasmania.
Results
Between February 2021 and December 2021, a total of 350 new patients from 10 sites, including one private and two regional, were entered into BRAIN. Additionally, BRAIN supports the world’s first registry trial in neuro-oncology, EX-TEM, addressing the optimal duration of post-radiation temozolomide; and BioBRAIN, a dedicated brain tumour translational program providing a pipeline for biospecimen collection matched with linked clinical data.
Conclusions
Here we report on the first data collection effort in brain tumours for Australia, which we believe to be unique worldwide given the number of sites and patients involved and the extent to which the registry resource is being leveraged to support clinical and translational research. Further directions such as passive data flow and data linkages, use of artificial intelligence and inclusion of patient-entered data are being explored.
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Champeaux-Depond C, Weller J, Constantinou P, Tuppin P, Froelich S. Five-year cause-specific survival after meningioma surgery. A nationwide population-based study. Neurochirurgie 2021; 68:280-288. [PMID: 34906556 DOI: 10.1016/j.neuchi.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/16/2021] [Accepted: 11/27/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Survival after meningioma surgery is often reported with inadequate allowance for competing causes of death. METHODS We processed the French administrative medical database (Système National des Données de Santé: SNDS), to retrieve appropriate cases of surgically treated meningioma. Cause-specific survival in meningioma-related death was analyzed with the Fine & Gray (F&G) and cause-specific (CS) Cox models to identify associated factors. RESULTS Five-year cumulative incidence was 2.85% for meningioma-related death and 6.3% for unrelated death (P<0.001). In the adjusted F&G and cause-specific Cox regression models for meningioma-related death, gender, age at surgery, co-morbidities, neurofibromatosis type 2, tumor insertion, tumor grade, cerebrospinal fluid (CSF) shunt insertion, preoperative embolization and need for redo surgery for recurrence emerged as independent prognostic factors of cause-specific survival (CSS) in meningioma-related death. CONCLUSION At 5 years, the risk of meningioma-unrelated death was 2.21-fold greater than the risk of dying from the meningioma disease. Five-year CSS after meningioma surgery was greater in younger adults with benign spinal meningioma with low comorbidity. Those with malignant cranial tumor requiring preoperative embolization or CSF shunting for associated hydrocephalus and with severely degraded overall health status showed a significantly increased risk of meningioma-related death. Redo surgery for recurrence failed to improve the risk of meningioma-related death. We recommend the use of net survival methods such as CSS in meningioma studies where unrelated mortality is predominant, as this approach results in more accurate estimates of disease risk and associated predictors.
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Affiliation(s)
- C Champeaux-Depond
- Department of Neurosurgery, Lariboisière Hospital, 75010 Paris, France; Inserm U1153, Statistics and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), ECSTRRA team, Université de Paris Paris, France.
| | - J Weller
- Agence Régionale de Santé, 2 bis, avenue Georges Brassens, CS 61002, 97743 Saint Denis CEDEX 9, France
| | - P Constantinou
- French National Health Insurance (CNAM), 50, avenue du Professeur André Lemierre, 75986 Paris CEDEX 20, France
| | - P Tuppin
- French National Health Insurance (CNAM), 50, avenue du Professeur André Lemierre, 75986 Paris CEDEX 20, France
| | - S Froelich
- Department of Neurosurgery, Lariboisière Hospital, 75010 Paris, France
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Khristov V, Shenoy G, Mau C, Mrowczynski O, Rizk E, Pu C, Specht CS, Aregawi D. Myxopapillary Ependymoma with Anaplastic Features: A Case Series and Review of the Literature. World Neurosurg 2021; 158:e735-e745. [PMID: 34800728 DOI: 10.1016/j.wneu.2021.11.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Myxopapillary ependymomas (MPEs) with anaplastic features are rarely reported, with only 21 cases identified to date, and long-term recurrence is rarely presented. A case series is presented to expand understanding of this disease by describing 3 unique cases, including 2 that arose from MPE after a prolonged clinical course. METHODS A literature review was performed, and 3 cases of MPE with anaplastic features from our institution were included. RESULTS Patient 1 was a 13-year-old boy who presented with an avidly enhancing intradural lumbar mass. On gross total resection, the tumor was found to be a solid mass with areas of myxopapillary architecture and MIB-1 (Ki-67) index of 12%. Patient 2 was a woman who initially presented at age 22 with a lumbosacral tumor that was treated with surgery and radiation. A recurrent tumor was resected at age 24. At age 50, the patient presented with a large heterogeneous exophytic mass in the sacrum extending into the presacral space and Ki-67 index of 8%. This was treated with complete resection. Patient 3 was a man who initially presented at age 35 with a lower thoracic, upper lumbar mass at L2 extending into the sacrum. Following resection and radiation, a metastatic focus followed an indolent course until causing pain at the age of 48. Ki-67 index was 16%. CONCLUSIONS The presented cases of MPE with anaplastic features make a total of 24 cases on record in the medical literature and demonstrate 2 examples of late recurrence.
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Affiliation(s)
- Vladimir Khristov
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.
| | - Ganesh Shenoy
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Christine Mau
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Oliver Mrowczynski
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Elias Rizk
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Cunfeng Pu
- Department of Pathology and Laboratory Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Charles S Specht
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA; Department of Pathology and Laboratory Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Dawit Aregawi
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
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Champeaux-Depond C, Weller J. Outcome After Protontherapy for Progression or Recurrence of Surgically Treated Meningioma. Brain Tumor Res Treat 2021; 9:46-57. [PMID: 34725984 PMCID: PMC8561229 DOI: 10.14791/btrt.2021.9.e9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/16/2021] [Accepted: 05/04/2021] [Indexed: 11/20/2022] Open
Abstract
Background To assess the outcome after meningioma surgery and protontherapy (PT). Methods We processed the French Système National des Données de Santé database to retrieve appropriate cases of meningiomas operated and irradiated between 2008 and 2017. Survival methods were implemented. Results One hundred ninety-three patients who received PT after meningioma surgery over a 10-year period were identified. Of the 193 patients, 75.6% were female. Median age at surgery was 50 years (interquartile range [IQR] 41–62). The median number of PT fractions was 31 (IQR 30–39) given over a median duration of 52 days (IQR 44–69). Fourteen patients (7.3%) also received photon radiotherapy and six patients (3.1%) stereotactic radiosurgery. Median follow-up was 4.4 years (IQR 3.86–4.71). Five-year progression-free survival (PFS) rate was 69% (95% confidence interval [CI] 62.1–76.6). For benign, atypical, and malignant meningioma, 5-year PFS rates were 71.5% (95% CI 64.4–79.4), 55.6% (95% CI 32.5–95), and 35.6% (95% CI 12.8–98.9), respectively (p<0.01). In the adjusted regression, tumour location (hazard ratio [HR]=0.1, 95% CI 0.05–0.22, p<0.001), aggressive meningioma (HR=2.26, 95% CI 1.1–4.66, p=0.027), and the need of cerebrospinal fluid (CSF) insertion for hydrocephalus (HR=3.51, 95% CI 1.32–9.31, p=0.012) remained significantly associated to the PFS. All grades considered, 5-year overall survival (OS) rates was 89.7% (95% CI 84.6–95.1). For benign, atypical, and malignant meningioma, 5-year OS rates were 93% (95% CI 88.7–97.4), 76.4% (95% CI 51.4–100), and 44.4% (95% CI 16.7–100), respectively (p<0.01). In the multivariable regression, an older age above 70 years (HR=5.95, 95% CI 2.09–16.89, p<0.001) associated to a high level of comorbidities (HR=5.31, 95% CI 1.43–19.78, p=0.013) and a malignant meningioma (HR=5.68, 95% CI 1.54–20.94, p=0.009) remained significantly associated to a reduced OS. Conclusion Five-year PFS and OS after meningioma surgery and PT is favourable but impaired for older patients with high level of morbidities, tumour of the convexity, malignant histopathology and for those requiring CSF shunting. Further inclusion and prolonged follow-up is required to assess other predictors such as sex, tumour volume, or given dose.
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Affiliation(s)
- Charles Champeaux-Depond
- Department of Neurosurgery, Lariboisière Hospital, Paris, France.,INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), ECSTRRA Team, Université de Paris, Paris, France.
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11
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Winter F, Furtner J, Pleyel A, Woehrer A, Callegari K, Hosmann A, Herta J, Roessler K, Dorfer C. How to predict the consistency and vascularity of meningiomas by MRI: an institutional experience. Neurol Res 2021; 43:693-699. [PMID: 33906575 DOI: 10.1080/01616412.2021.1922171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE In surgery for meningiomas tumor location and extension is currently the only MRI characteristic used to predict the feasibility and difficulty of the resection. Key surgical tumor characteristics such as consistency and vascularity remain obscured until the tumor is exposed. We therefore aimed to identify MRI sequences able to predict these crucial meningioma features. METHODS We retrospectively reviewed our imaging database on cranial meningiomas and correlated MRI T2W, T1W, and FLAIR images with the consistency and vascularity reported by the surgeon in the operative notes. The reported consistency was classified into three grades [°I (soft) to °III (hard)]. Vascularity was grouped into little (°I) versus strong (°II). MRI signal intensity (SI) ratios were calculated with ROIs in the meningioma, the buccinator muscle and the frontal white matter. RESULTS Of the 172 reviewed patients, 44 met the strict inclusion criteria with respect to the quality of the OR notes. The included meningiomas were located at the convexity (11/44), falcine (3/44), skull base (14/44), and posterior fossa (16/44). Twenty-four meningiomas (54.5%) were classified as consistency grade (°)I, seven (15.9%) °II, and thirteen (29.5%) °III. The grade of vascularization was little in 12 and strong in 14. The higher the ratio on T2W images the softer (p = 0.020) and the more vascularized (p = 0.001) the tumor presented. DISCUSSION T2W MR images may be helpful to characterize meningiomas with regard to the expected consistency and grade of vascularization.
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Affiliation(s)
- Fabian Winter
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Julia Furtner
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna. Vienna, Austria
| | - Alexander Pleyel
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna. Vienna, Austria
| | - Adelheid Woehrer
- Department of Neurology, Division of Neuropathology and Neurochemistry, Medical University of Vienna, Vienna, Austria
| | - Keri Callegari
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, USA
| | - Arthur Hosmann
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Johannes Herta
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Karl Roessler
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Christian Dorfer
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
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12
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Abstract
Well-circumscribed intra-axial CNS tumors encompass a wide variety of gliomas and glioneuronal tumors, usually corresponding to WHO grades I and II. Nonetheless, sometimes high-grade 'diffuse' gliomas such as gliosarcoma and giant cell glioblastoma can be relatively circumscribed but are often found to have foci of diffuse infiltration on careful examination, harboring distinct molecular alterations. These tumors are excluded from the discussion in this chapter with the current review emphasizing on lower-grade entities to include a brief description of their histology and associated molecular findings. Like elsewhere in brain biopsy evaluation, imaging is crucial and acts as a surrogate to gross examination. Given the circumscribed nature of these tumors, surgery alone is the mainstay treatment in most entities.
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Champeaux-Depond C, Weller J, Froelich S, Resche-Rigon M. A nationwide population-based study on overall survival after meningioma surgery. Cancer Epidemiol 2020; 70:101875. [PMID: 33360358 DOI: 10.1016/j.canep.2020.101875] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/17/2020] [Accepted: 12/05/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND There are very few nationwide studies on meningioma outcome, the most common primary intracranial tumour. METHODS We processed the French Système National des Données de Santé (SNDS) database using an algorithm combining the type of surgical procedure and the International Classification of Diseases to retrieve all cases of meningiomas operated between 2007 and 2017. A survival analysis was performed. RESULTS This nationwide study found 28 773 patients of which 75 % were female. Median age at surgery was 59 years, IQR[49-68]. Cranial convexity (24.4 %) and middle skull base (21.7 %) were the most common locations. 91.3 % of the tumours were benign and 2.6 % malignant.7.5 % of the patients underwent redo surgery, 9.1 % radiotherapy (RT) and 3.2 % stereotactic radiosurgery for recurrence. Median follow-up was 5.3 years 95 % CI [5.24-5.35]. 0.64 % of the patients died within a month of surgery and 2.1 % within a year. Overall survival (OS) rates at 5 and 10 years respectively were: 92.6 %, 95 %CI[92.3, 93] and 85 %, 95 %CI[84.3, 85.8]. In the multivariable analysis, female gender (HR = 0.64, 95 %CI[0.59, 0.69], p < 0.001), older age at surgery (HR= 1.07, 95 %CI[1.06, 1.07], p < 0.001), type 2 neurofibromatosis (HR= 3.89, 95 %CI[2.62, 5.76], p < 0.001), parasagittal (HR= 1.2, 95 %CI[1.05, 1.37], p = 0.00944) or falx cerebri location (HR= 1.18, 95 %CI[1.01, 1.37], p = 0.0343), atypical or (HR= 1.34, 95 %CI[1.15, 1.56], p < 0.001) malignant histology (HR= 2.34, 95 %CI[2.01, 2.73], p < 0.001), redo surgery (HR=1.81, 95 %CI[1.6, 2.04], p < 0.001), progressing meningioma (HR=1.34, 95 %CI[1.05, 1.71], p = 0.0175) or RT for recurrence (HR=2.17, 95 %CI[1.95, 2.4], p < 0.001) were established as independent prognostic factors of the OS. CONCLUSION In this registry-based study, OS after meningioma surgery is good and is even better in women, younger adults and those with convexity and benign tumour. We also found that NF2 patients and those required redo surgery or additional treatment for uncontrolled meningioma disease are further at risk of death.
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Affiliation(s)
- Charles Champeaux-Depond
- Department of Neurosurgery, Lariboisière Hospital, 75010, Paris, France; INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), ECSTRRA Team, Université de Paris, France.
| | - Joconde Weller
- Agence régionale de santé, 2bis, Avenue Georges Brassens, CS 61002 - 97743, Saint Denis CEDEX 9, France
| | | | - Matthieu Resche-Rigon
- INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), ECSTRRA Team, Université de Paris, France
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14
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Champeaux-Depond C, Weller J, Resche-Rigon M. Neurofibromatosis type 2: A nationwide population-based study focused on survival after meningioma surgery. Clin Neurol Neurosurg 2020; 198:106236. [DOI: 10.1016/j.clineuro.2020.106236] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 08/25/2020] [Accepted: 09/12/2020] [Indexed: 11/30/2022]
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Champeaux-Depond C, Constantinou P, Weller J. Cause-Specific Survival After Meningioma Surgery: A Nationwide Population-Based Competing Risk Study. World Neurosurg 2020; 146:e67-e75. [PMID: 33096279 DOI: 10.1016/j.wneu.2020.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/01/2020] [Accepted: 10/03/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Survival after meningioma surgery often is reported with inadequate allowance for competing causes of death. METHODS We processed the French Système National des Données de Santé database using an algorithm combining the type of surgical procedure and the International Classification of Diseases to retrieve appropriate cases of meningiomas. The cumulative incidence of meningioma-related death was the primary end point. A competing risk analysis was performed to identify factors associated with meningioma-specific death of patients who underwent meningioma surgery. RESULTS The risk of meningioma-related death at 1, 2, and 3 years respectively was 2.4%, 95% confidence interval [CI] 2-2.7; 3%, 95% CI 2.6-3.4; and 3.1%, 95% CI 2.7-3.6. In the adjusted Fine-Gray competing risk regression for meningioma cause-specific survival, age at surgery (subdistribution hazard ratio [SHR] 1.07, 95% CI 1.05-1.09, P < 0.001), mortality-related morbidity index (SHR 1.68, 95% CI 1.07-2.63, P = 0.025), expenditure-related morbidity index (SHR 1.06, 95% CI 1.03-1.09, P < 0.001), spinal location (SHR 0.2, 95% CI 0.08-0.47, P < 0.001), cerebrospinal fluid shunt (SHR 3.13, 95% CI 1.9-5.16, P < 0.001), grade (SHR 1.88, 95% CI 1.13-3.14, P = 0.015) redo surgery for recurrence (SHR 1.6, 95% CI 1.01-2.51, P = 0.043), and progressing meningioma (SHR 2.87, 95% CI 1.23-6.68, P = 0.015) were established as independent prognostic factors of meningioma-related death. CONCLUSIONS Cause-specific survival after meningioma surgery is greater in younger, low-comorbidity adults with spinal and benign meningioma. Those with an intracranial, progressing malignant tumor requiring cerebrospinal fluid shunting and having a severe global health-state have a significant increased risk of meningioma-related death. Redo surgery failed to improve the outcome. We recommend the use of competing risk model in meningioma studies in which unrelated mortality may be substantial, as this approach results in more accurate estimates of disease risk and associated predictors.
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Affiliation(s)
- Charles Champeaux-Depond
- Department of Neurosurgery, Lariboisière Hospital, Paris, France; INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), ECSTRRA team, Université de Paris, Paris, France.
| | - Panayotis Constantinou
- Center for Research in Epidemiology and Population Health, French National Institute of Health and Medical Research (INSERM U1018), Université Paris-Saclay, Université Paris-Sud; French National Health Insurance (Cnam), Paris, France
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16
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Kang H, Song SW, Ha J, Won YJ, Park CK, Yoo H, Jung KW. A Nationwide, Population-Based Epidemiology Study of Primary Central Nervous System Tumors in Korea, 2007-2016: A Comparison with United States Data. Cancer Res Treat 2020; 53:355-366. [PMID: 33070557 PMCID: PMC8053868 DOI: 10.4143/crt.2020.847] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 10/06/2020] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The purpose of this study was to determine the epidemiologic characteristics and survival of patients with primary brain and other central nervous system (CNS) tumors in Korea and to compare our findings with those from the United States. Materials and Methods We collected data on primary brain and CNS tumors diagnosed between 2007 and 2016 from the Korea Central Cancer Registry. The age-standardized incidence rates (ASRs) and 5-year relative survival rates (RSRs) were evaluated. We applied the classification and definitions of the Central Brain Tumor Registry of the United States to our analysis for direct comparison with United States data. RESULTS A total of 115,050 primary brain and CNS tumors were identified, and the ASR of all tumors was 22.01 per 100,000 individuals, which was lower than the 23.41 in the United States. However, the ASR of malignant tumors was significantly lower herein (4.27) than in the United States (7.08). Meningeal tumors were the most common histologic group among all tumors (ASR, 8.32). The 5-year RSR of all primary brain and other CNS tumors was 86.4%, and that of all malignant tumors was 44.1%, which was higher than the 35.8% observed in the United States. Among malignant tumors, glioblastomas had the lowest 5-year RSR (12.1%). CONCLUSION In Korea, malignant brain and other CNS tumors have a lower incidence and better survival outcome.
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Affiliation(s)
- Ho Kang
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
| | - Sang Woo Song
- Department of Neurosurgery, Gangneung Asan Hospital, Gangneung, Korea
| | - Johyun Ha
- Division of Cancer Registration and Surveillance, National cancer center, Goyang, Korea
| | - Young-Joo Won
- Division of Cancer Registration and Surveillance, National cancer center, Goyang, Korea.,Department of Cancer Control and Population Health, National cancer center, Goyang, Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
| | - Heon Yoo
- Neuro-Oncology clinic, National cancer center, Goyang, Korea
| | - Kyu-Won Jung
- Division of Cancer Registration and Surveillance, National cancer center, Goyang, Korea
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17
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Champeaux C, Houston D, Dunn L, Resche-Rigon M. Intracranial WHO grade I meningioma: a competing risk analysis of progression and disease-specific survival. Acta Neurochir (Wien) 2019; 161:10.1007/s00701-019-04096-9. [PMID: 31707459 DOI: 10.1007/s00701-019-04096-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 10/04/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Studies on meningioma are reported with inadequate allowance for competing causes of progression or death. The aim of this study was to describe the outcome of patients with intracranial WHO grade I meningioma and identify factors that may influence disease progression and cause-specific survival. METHODS Pathology reports and clinical data of 505 WHO grade I meningiomas treated between January 2003 and December 2017 were retrospectively reviewed at a single institution. We estimated a cumulative incidence function for progression and cause-specific mortality. A competing risk analysis was conducted on clinical and histological criteria. Median follow-up was 6.2 years. RESULTS A total of 530 surgical resections were performed on 505 cases. Forty-one patients received radiotherapy (RT). At data collection, 84 patients had died of their meningioma disease or demonstrated a recurrence eventually treated by redo surgery or RT. The risks of recurrence or meningioma-related death at 5 years were 16.2%, 95%CI[12.5, 20], whereas 5-year overall survival was 86.1%, 95%CI[82.8, 89.6]. In the multivariable Fine-Gray regression for a competing risk model, venous sinus invasion (SHR = 1.8, 95%CI[1.1, 2.9], p0.028), extent of resection (SHR = 0.2, 95%CI[0.1, 0.3], p < 0.001), and progressing meningioma (SHR = 7, 95%CI[3.3, 14.8], p < 0.001) were established as independent prognostic factors of cause-specific death or meningioma progression. In contrast, age at diagnosis < 65 years (HR = 1.1, 95%CI[1, 1.1], p < 0.001) and redo surgery for meningioma recurrence (HR = 2.6, 95%CI[1.4, 5], p = 0.00252) were predictors of the overall survival. CONCLUSIONS In this large series, WHO grade I meningioma treatment failure correlated with venous sinus invasion, incomplete resection, and progressing tumour; shorter survival correlated with increased age and redo surgery for recurrence. We recommend the cumulative incidence competing risk approach in WHO grade I meningioma studies where unrelated mortality may be substantial, as this approach results in more accurate estimates of disease risk and associated predictors.
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Affiliation(s)
- Charles Champeaux
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK.
- INSERM U1153, Statistic and Epidemiologic Research Centre Sorbonne Paris Cite (CRESS), ECSTRA team, Universite Diderot - Paris 7, USPC, Paris, France.
- Department of Neurosurgery, Lariboisière Hospital, 2, rue Ambroise-Paré, Cedex 10, 75475, Paris, France.
| | - Deborah Houston
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK
| | - Laurence Dunn
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK
| | - Matthieu Resche-Rigon
- INSERM U1153, Statistic and Epidemiologic Research Centre Sorbonne Paris Cite (CRESS), ECSTRA team, Universite Diderot - Paris 7, USPC, Paris, France
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18
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Kang JM, Ha J, Hong EK, Ju HY, Park BK, Shin SH, Won YJ, Jung KW, Park HJ. A Nationwide, Population-Based Epidemiologic Study of Childhood Brain Tumors in Korea, 2005–2014: A Comparison with United States Data. Cancer Epidemiol Biomarkers Prev 2018; 28:409-416. [DOI: 10.1158/1055-9965.epi-18-0634] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 08/29/2018] [Accepted: 10/16/2018] [Indexed: 11/16/2022] Open
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Wang KW, de Souza RJ, Fleming A, Johnston DL, Zelcer SM, Rassekh SR, Burrow S, Thabane L, Samaan MC. Birth weight and body mass index z-score in childhood brain tumors: A cross-sectional study. Sci Rep 2018; 8:1642. [PMID: 29374278 DOI: 10.1038/s41598-018-19924-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 01/11/2018] [Indexed: 01/31/2023] Open
Abstract
Children with brain tumors (CBT) are at higher risk of cardiovascular disease and type 2 diabetes compared to the general population, in which birth weight is a risk factor for these diseases. However, this is not known in CBT. The primary aim of this study was to explore the association between birth weight and body mass measures in CBT, compared to non-cancer controls. This is a secondary data analysis using cross-sectional data from the CanDECIDE study (n = 78 CBT and n = 133 non-cancer controls). Age, sex, and birth weight (grams) were self-reported, and confirmed through examination of the medical records. Body mass index (BMI) was calculated from height and weight measures and reported as kg/m2. BMI z-scores were obtained for subjects under the age of 20 years. Multivariable linear regression was used to evaluate the relationship between birth weight and BMI and BMI z-score, adjusted for age, sex, puberty, and fat mass percentage. Higher birth weight was associated with higher BMI and BMI z-score among CBT and controls. In conclusion, birth weight is a risk factor for higher body mass during childhood in CBT, and this may help the identification of children at risk of future obesity and cardiometabolic risk.
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Wang KW, Chau R, Fleming A, Banfield L, Singh SK, Johnston DL, Zelcer SM, Rassekh SR, Burrow S, Valencia M, de Souza RJ, Thabane L, Samaan MC. The effectiveness of interventions to treat hypothalamic obesity in survivors of childhood brain tumours: a systematic review. Obes Rev 2017; 18:899-914. [PMID: 28544764 DOI: 10.1111/obr.12534] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 02/12/2017] [Accepted: 02/16/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Survivors of childhood brain tumours (SCBT) are at risk of type 2 diabetes and cardiovascular diseases. Obesity is a major driver of cardiometabolic diseases in the general population, and interventions that tackle obesity may lower the risk of these chronic diseases. The goal of this systematic review was to summarize current evidence for the presence of interventions to manage obesity, including hypothalamic obesity, in SCBT. METHODS The primary outcome of this review was the body mass index z-score change from baseline to the end of the intervention and/or follow-up. Literature searches were conducted in PsycINFO, CINAHL, the Cochrane Library, Medline, SPORTDiscus, EMBASE and PubMed. Two reviewers completed study evaluations independently. RESULTS Eleven publications were included in this systematic review (lifestyle intervention n = 2, pharmacotherapy n = 6 and bariatric surgery n = 3). While some studies demonstrated effectiveness of interventions to manage obesity in SCBT and alter markers of obesity and cardiometabolic risk, the evidence base was limited and of low quality, and studies focused on hypothalamic obesity. We conclude that there is urgent need to conduct adequately powered trials of sufficient duration, using existing and novel therapies to manage obesity, reduce the burden of cardiometabolic disorders and improve outcomes in SCBT.
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Affiliation(s)
- K-W Wang
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - R Chau
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - A Fleming
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - L Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - S K Singh
- Division of Neurosurgery, Department of Surgery, McMaster Children's Hospital, Hamilton, Ontario, Canada.,McMaster Stem Cell and Cancer Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - D L Johnston
- Division of Pediatric Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - S M Zelcer
- Pediatric Hematology Oncology, Children's Hospital, London Health Sciences Center, London, Ontario, Canada
| | - S R Rassekh
- Division of Pediatric Hematology/ Oncology/BMT, Department of Pediatrics, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - S Burrow
- Division of Orthopedic Surgery, Department of Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada
| | - M Valencia
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - R J de Souza
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - L Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.,Centre for Evaluation of Medicines, St. Joseph's Health Care, Hamilton, Ontario, Canada.,Biostatistics Unit, St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - M C Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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21
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Fuentes-Raspall R, Solans M, Roca-Barceló A, Vilardell L, Puigdemont M, Del Barco S, Comas R, García-Velasco A, Astudillo A, Carmona-Garcia MC, Marcos-Gragera R. Descriptive epidemiology of primary malignant and non-malignant central nervous tumors in Spain: Results from the Girona Cancer Registry (1994-2013). Cancer Epidemiol 2017; 50:1-8. [PMID: 28738268 DOI: 10.1016/j.canep.2017.07.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 06/15/2017] [Accepted: 07/06/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Systematic registration of non-malignant central nervous system (CNS) tumors is a rare practice among European cancer registries. Thus, the real burden of all CNS tumors across Europe is underestimated. The Girona Cancer Registry provides here the first data on CNS tumor incidence and survival trends in Spain for all histological types, including malignant and non-malignant tumors. METHODS Data on all incident cases of primary CNS tumors notified to the Girona population-based cancer registry from 1994 to 2013 (n=2,131) were reviewed. Incidences rates (IRs) were standardized to the 2013 European population and annual percentage changes (EAPC) were estimated using a piecewise log linear model. 1- and 5-year observed (OS) and relative survival (RS) were also calculated. Results were expressed by sex, age-group, histological subtype and behavior. RESULTS The overall IR was 16.85 and increased across the period of study (EAPC=+2.2%). The proportion and IRs of malignant (50.2%; IR=9.35) and non-malignant cases (49.8%; IR=9.14) were similar; however, non-malignant tumors were more frequent in women (sex ratio=0.63). The most frequently reported histologies were meningioma (27.6%; IR=5.11) and glioblastoma (22.2%; IR=4.15), which also accounted for the highest and lowest 5-year RS (80.2%; 3.7%, respectively). Globally, 5-year RS was lower in men (42.6% vs. 58.3%, respectively) and in the elderly (64.9% for 0-14years vs. 23.0% for >74years). CONCLUSION This study presents a comprehensive overview of the epidemiology of malignant and non-malignant CNS primary tumors from the well-established region-wide Girona Cancer Registry (1994-2013). Incidence rates were recovered for all histologies. Survival is still dramatically associated to both age and histological subtype.
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Affiliation(s)
- Rafael Fuentes-Raspall
- Radiation Oncology Service, Josep Trueta University Hospital, Catalan Institute of Oncology, Avinguda de França, S/N, 17007 Girona, Spain.
| | - Marta Solans
- CIBER in Epidemiology and Public Health (CIBERESP), University of Girona (UdG), C/ Universitat de Girona 10,17003 Girona, Spain, Spain; Research Group on Statistics, Econometrics and Health (GRECS), University of Girona (UdG), C/ Universitat de Girona 10,17003 Girona, Spain; Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Carrer del Sol, 15, 17004 Girona, Spain.
| | - Aina Roca-Barceló
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Carrer del Sol, 15, 17004 Girona, Spain.
| | - Loreto Vilardell
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Carrer del Sol, 15, 17004 Girona, Spain.
| | - Montse Puigdemont
- Hospital Cancer Registry, Josep Trueta University Hospital, Catalan Institute of Oncology, Av de França, 17007, Girona, Spain; Nursing Department, University of Girona, Av de França, 17007, Girona, Spain.
| | - Sonia Del Barco
- Medical Oncology Service, Josep Trueta University Hospital, Catalan Institute of Oncology, Av de França, 17007, Girona, Spain.
| | - Raquel Comas
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Carrer del Sol, 15, 17004 Girona, Spain.
| | - Adelaida García-Velasco
- Medical Oncology Service, Josep Trueta University Hospital, Catalan Institute of Oncology, Av de França, 17007, Girona, Spain.
| | - Aurora Astudillo
- Department of Pathology, Central University Hospital of Asturias (HUCA), Av. de Roma, 33006 Oviedo, Spain.
| | - Mª Carme Carmona-Garcia
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Carrer del Sol, 15, 17004 Girona, Spain; Emergency Department, Josep Trueta University Hospital, Catalan Institute of Oncology, Av de França, 17007, Girona, Spain.
| | - Rafael Marcos-Gragera
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona (UdG), C/ Universitat de Girona 10,17003 Girona, Spain; Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Carrer del Sol, 15, 17004 Girona, Spain.
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22
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Wang KW, Souza RJD, Fleming A, Singh SK, Johnston DL, Zelcer SM, Rassekh SR, Burrow S, Scheinemann K, Thabane L, Samaan MC. Adiposity in childhood brain tumors: A report from the Canadian Study of Determinants of Endometabolic Health in Children (CanDECIDE Study). Sci Rep 2017; 7:45078. [PMID: 28327649 PMCID: PMC5361156 DOI: 10.1038/srep45078] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 02/20/2017] [Indexed: 01/07/2023] Open
Abstract
Children with brain tumors (CBT) are at high risk of cardiovascular diseases and type 2 diabetes compared to the general population. Recently, adiposity has been reported to be more informative for cardiometabolic risk stratification than body mass index (BMI) in the general population. The goal of this study is to describe the adiposity phenotype in CBT, and to establish adiposity determinants. We recruited CBT (n = 56) and non-cancer controls (n = 106). Percent body fat (%FM), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were measured to determine total and central adiposity, respectively. Regression analyses were used to evaluate adiposity determinants. CBT had higher total and central adiposity compared to non-cancer controls despite having similar BMI measurements. Those with tumors at the supratentorial region had increased total and central adiposity, while those who received radiotherapy had increased total adiposity. In conclusion, CBT have increased total and central adiposity in the presence of similar BMI levels when compared to non-cancer controls. Adiposity, especially central adiposity, is a potential cardiometabolic risk factor present relatively early in life in CBT. Defining interventions to target adiposity may improve long-term outcomes by preventing cardiometabolic disorders in CBT.
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Affiliation(s)
- Kuan-Wen Wang
- Medical Sciences Program, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Russell J de Souza
- Medical Sciences Program, McMaster University, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Adam Fleming
- Medical Sciences Program, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Sheila K Singh
- Division of Neurosurgery, Department of Surgery, McMaster Children's Hospital, Hamilton, Ontario, Canada.,McMaster Stem Cell and Cancer Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Donna L Johnston
- Division of Pediatric Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Shayna M Zelcer
- Pediatric Hematology Oncology, London Health Sciences Center, London, Ontario, Canada
| | - Shahrad Rod Rassekh
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Sarah Burrow
- Division of Orthopedic Surgery, Department of Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada
| | - Katrin Scheinemann
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Hematology/Oncology, University Children's Hospital, Basel, Switzerland
| | - Lehana Thabane
- Medical Sciences Program, McMaster University, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.,Centre for Evaluation of Medicines, St. Joseph's Health Care, Hamilton, ON, Canada.,Biostatistics Unit, St. Joseph's Healthcare-Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Medical Sciences Program, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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23
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Wang KW, Fleming A, Singh SK, Banfield L, de Souza RJ, Thabane L, Samaan MC. Evaluating overweight and obesity prevalence in survivors of childhood brain tumors: a systematic review protocol. Syst Rev 2017; 6:43. [PMID: 28253910 PMCID: PMC5335753 DOI: 10.1186/s13643-017-0439-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 02/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overweight and obesity are well-known risk factors for cardiometabolic diseases including hypertension, myocardial infarction, stroke, and type 2 diabetes in the general population. Survivors of childhood brain tumors (SCBT) are at risk of premature mortality, and recent evidence suggests that these cardiometabolic diseases are potential emerging determinants of survival and quality of life. Therefore, the rates of overweight and obesity in this population need to be examined to assess their impact on outcomes. The objective of this systematic review is to examine the prevalence of overweight and obesity in SCBT. The secondary aim of this review is to evaluate whether SCBT have higher adiposity compared to the general population. METHODS Searches will be conducted in MEDLINE, CINAHL, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PubMed, and Database of Abstracts of Reviews of Effect. For gray literature, we will search ProQuest Dissertations and Theses A&I and Web of Science. Two reviewers will independently screen all articles against predetermined eligibility criteria and complete data abstraction, risk of bias, and quality assessments. The primary outcome includes the prevalence of overweight or obesity. The secondary outcomes involve waist-to-hip ratio, waist-to-height ratio, body fat percentage, and skinfold thickness. Meta-analysis will be performed when two or more studies with similar design, populations, and outcomes are available. DISCUSSION This review will summarize current data on the prevalence of overweight and obesity in SCBT. This will help the development of an understanding of the scale of overweight and obesity in this population and guide the design of interventions that will improve outcomes. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016051035.
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Affiliation(s)
- Kuan-Wen Wang
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada.,Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Adam Fleming
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada.,Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Sheila K Singh
- Division of Neurosurgery, Department of Surgery, McMaster Children's Hospital, Hamilton, Ontario, Canada.,McMaster Stem Cell and Cancer Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Russell J de Souza
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.,Centre for Evaluation of Medicines, St. Joseph's Health Care, Hamilton, Ontario, Canada.,Biostatistics Unit, St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada. .,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada. .,Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada. .,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
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24
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Wang KW, Valencia M, Banfield L, Chau R, Fleming A, Singh SK, Burrow S, de Souza RJ, Thabane L, Samaan MC. The effectiveness of interventions to treat obesity in survivors of childhood brain tumors: a systematic review protocol. Syst Rev 2016; 5:101. [PMID: 27301869 PMCID: PMC4908756 DOI: 10.1186/s13643-016-0274-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/27/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Pediatric brain tumors are the most common solid tumors in children. Advances in understanding the hallmarks of cancer biology and novel therapies have led to an increasing number of survivors of childhood brain tumors (SCBT). However, these survivors are at an increased risk of obesity and cardiometabolic disorders that affect their quality of life and lifespan. It is important to define effective strategies to treat and prevent obesity in this population. This systematic review aims to investigate the effectiveness of lifestyle interventions, pharmacotherapy, and bariatric surgery on treating obesity in SCBT. METHODS Searches will be conducted in PubMed, MEDLINE, EMBASE, PsycINFO, SPORTDiscus, CINAHL, Cochrane Database of Systematic Review, Cochrane Central Register of Controlled Trials (CENTRAL), and Database of Abstracts of Reviews of Effect (DARE). In addition, ClinicalTrials.gov and ProQuest Dissertations and Theses A&I will be searched to identify relevant gray literature. The reference lists of eligible articles will be searched for additional studies. All screening, quality assessment, and data abstraction will be done independently by two reviewers. We will perform meta-analysis if there are sufficient studies. DISCUSSION This review will summarize evidence for the effectiveness of interventions used to reduce obesity risk in SCBT. This has significant implications for SCBT, as it can identify gaps in knowledge and provide insights into the development of new interventions to manage obesity in survivors, which may improve their outcomes. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015025909.
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Affiliation(s)
- Kuan-Wen Wang
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada
| | - Marlie Valencia
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Ruth Chau
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada
| | - Adam Fleming
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada.,Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Sheila K Singh
- Division of Neurosurgery, Department of Surgery, McMaster Children's Hospital, Hamilton, Ontario, Canada.,McMaster Stem Cell and Cancer Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Sarah Burrow
- Division of Orthopedic Surgery, Department of Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada
| | - Russell J de Souza
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.,Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.,Centre for Evaluation of Medicines, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Biostatistics Unit, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada. .,Division of Pediatric Endocrinology, McMaster Children's Hospital, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada. .,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
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25
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Karim-Kos HE, Hackl M, Mann G, Urban C, Woehrer A, Slavc I, Ladenstein R. Trends in incidence, survival and mortality of childhood and adolescent cancer in Austria, 19942011. Cancer Epidemiol 2016; 42:72-81. [DOI: 10.1016/j.canep.2016.03.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 02/25/2016] [Accepted: 03/23/2016] [Indexed: 11/30/2022]
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26
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Liu M, Ouyang YU, Lv F. Computed tomography and magnetic resonance imaging findings of intrasellar schwannoma: A case report and literature review. Oncol Lett 2016; 11:2315-2319. [PMID: 26998169 DOI: 10.3892/ol.2016.4182] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 01/13/2016] [Indexed: 11/06/2022] Open
Abstract
Intrasellar schwannoma is extremely rare, and only a few cases have been reported in the literature to date. In the present study, the clinical, radiological and pathological features of a 50-year-old male patient with primary intrasellar schwannoma are presented. The patient presented with decreased visual acuity, and a subsequent computed tomography (CT) scan revealed a giant well-demarcated intrasellar mass with suprasellar extension, without cavernous sinus invasion. The lesion was slightly hyperdense with heterogeneous enhancement. On magnetic resonance imaging (MRI), the mass was isointense on T1 weighted images (WI), and slightly hyperintense on T2WI, with significant heterogeneous enhancement. Previous literature was reviewed to summarize the CT and MRI characteristics of intrasellar schwannoma. Despite the rarity of this tumor, intrasellar schwannoma must be included in the differential diagnosis of intrasellar lesions.
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Affiliation(s)
- Mengqi Liu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Y U Ouyang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Fajin Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
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27
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Pouchieu C, Baldi I, Gruber A, Berteaud E, Carles C, Loiseau H. Descriptive epidemiology and risk factors of primary central nervous system tumors: Current knowledge. Rev Neurol (Paris) 2015; 172:46-55. [PMID: 26708326 DOI: 10.1016/j.neurol.2015.10.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 10/08/2015] [Accepted: 10/09/2015] [Indexed: 11/16/2022]
Abstract
Although comparisons are difficult due to differences in methodologies, the annual incidence rates of central nervous system (CNS) tumors range from 8.5 to 21.4/100,000 population according to cancer registries, with a predominance of neuroepithelial tumors in men and meningiomas in women. An increase in the incidence of CNS tumors has been observed during the past decades in several countries. It has been suggested that this trend could be due to aging of the population, and improvements in diagnostic imaging and healthcare access, but these factors do not explain differences in incidence by gender and histological subtypes. Several etiological hypotheses related to intrinsic (sociodemographic, anthropometric, hormonal, immunological, genetic) and exogenous (ionizing radiation, electromagnetic fields, diet, infections, pesticides, drugs) risk factors have led to analytical epidemiological studies to establish relationships with CNS tumors. The only established environmental risk factor for CNS tumors is ionizing radiation exposure. However, for other risk factors, studies have been inconsistent and inconclusive due to systematic differences in study design and difficulties in accurately measuring exposures. Thus, the etiology of CNS tumors is complex and may involve several genetic and/or environmental factors that may act differently according to histological subtype.
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Affiliation(s)
- C Pouchieu
- ISPED, Équipe Santé Travail Environnement, Université de Bordeaux, 33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219, Bordeaux Population Health Center, 33000 Bordeaux, France
| | - I Baldi
- ISPED, Équipe Santé Travail Environnement, Université de Bordeaux, 33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219, Bordeaux Population Health Center, 33000 Bordeaux, France; Service de médecine du travail, CHU de Bordeaux, 33000 Bordeaux, France.
| | - A Gruber
- ISPED, Équipe Santé Travail Environnement, Université de Bordeaux, 33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219, Bordeaux Population Health Center, 33000 Bordeaux, France
| | - E Berteaud
- ISPED, Équipe Santé Travail Environnement, Université de Bordeaux, 33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219, Bordeaux Population Health Center, 33000 Bordeaux, France; Service de médecine du travail, CHU de Bordeaux, 33000 Bordeaux, France
| | - C Carles
- ISPED, Équipe Santé Travail Environnement, Université de Bordeaux, 33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219, Bordeaux Population Health Center, 33000 Bordeaux, France; Service de médecine du travail, CHU de Bordeaux, 33000 Bordeaux, France
| | - H Loiseau
- Service de neurochirurgie, CHU de Bordeaux, 33000 Bordeaux, France
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Abstract
In 2010 it was estimated that >688 000 Americans were living with a primary brain tumor (PBT) corresponding to a U.S. prevalence rate of approximately 221.8 per 100 000 people. Five-year survival is 96.1% in nonmalignant PBTs, 34% in malignant PBTs for all ages, and 71% in children [1985-2005]. Case fatality rates have decreased in the U.S. since the 1970's for nonmalignant PBTs and for medulloblastoma, oligodendroglioma, and astrocytoma. Statistics of increasing survival highlight the importance of rehabilitation interventions to improve function and quality of life in survivors. PBT motor dysfunction is multifactorial, occurring as a result of direct effects of tumor and/or swelling or as a result of treatments; etiologies include encephalopathy, myopathy, neuropathy, infection, poor nutrition, metabolic factors, emotional factors, impaired perception/vision/cognition and complications of immobility. Motor dysfunction may lead to: impaired mobility, impaired activities of daily living, risk for complications of immobility, falls, pain, anxiety/depression, and loss of functional independence and quality of life. Rehabilitation treatment strategies target specific causes of motor dysfunction to improve functional independence and quality of life. This article reviews current knowledge and controversy regarding the role of rehabilitation for motor disorders in PBT patients.
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Affiliation(s)
- David S Kushner
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida (D.S.K.); Department of Neurology and Rehabilitation, University of Illinois, College of Medicine (C.A.)
| | - Christina Amidei
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida (D.S.K.); Department of Neurology and Rehabilitation, University of Illinois, College of Medicine (C.A.)
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29
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