Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec 21;4(1):vdab183.
doi: 10.1093/noajnl/vdab183. eCollection 2022 Jan-Dec.

Survival rates of children and young adolescents with CNS tumors improved in the Netherlands since 1990: A population-based study

Raoull Hoogendijk  1 , Jasper van der Lugt  1 , Dannis van Vuurden  1 , Leontien Kremer  1   2 , Pieter Wesseling  1   3 , Eelco Hoving  1   4 , Henrike E Karim-Kos  1   5
Affiliations

Survival rates of children and young adolescents with CNS tumors improved in the Netherlands since 1990: A population-based study

Raoull Hoogendijk et al. Neurooncol Adv. .

Abstract

Introduction: Survival of children with central nervous system (CNS) tumors varies largely between countries. For the Netherlands, detailed population-based estimation of incidence, survival, and mortality of pediatric CNS tumors are lacking but are needed to evaluate progress.

Methods: All CNS tumors diagnosed in patients <18 years during 1990-2017 were selected from the Netherlands Cancer Registry. Other than pilocytic astrocytomas, nonmalignant tumors were included since 2000. Incidence and mortality trends were evaluated by average annual percentage change (AAPC). Changes over time in the five-year observed survival (5-year OS) were evaluated by Poisson regression models adjusted for follow-up time.

Results: Between 1990 and 2017, 2057 children were diagnosed with a malignant CNS tumor and 885 with a pilocytic astrocytoma. During 2000-2017, 695 children were diagnosed with other nonmalignant CNS tumors. Incidence rates of malignant tumors remained stable, while pilocytic astrocytomas and other nonmalignant tumors increased by 2.0% and 2.4% per year, respectively. The 5-year OS rates improved for all groups; however, improvement for malignant tumors was not constant over time. The contribution of malignant tumors located at the optic nerve tumors was 1% in 2000-2009. However, shifting from pilocytic astrocytomas, increased to 6% in 2010-2017, impacting survival outcomes for malignant tumors.

Conclusion: Survival rates of CNS tumors improved over time but were not accompanied by a decreasing mortality rate. The observed temporary survival deterioration for malignant tumors appears to be related to changes in diagnostics and registration practices. Whether differences in treatment regimens contribute to this temporary decline in survival needs to be verified.

Keywords: CNS; epidemiology; incidence; survival; time trends.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
(A) Relative contribution of WHO grade per time period for malignant tumors and (B) the percentage of microscopic verification over time for patients <18 years diagnosed with a CNS tumor in the Netherlands between 1990 and 2017.
Figure 2.
Figure 2.
Trends in incidence for (A) overall and main tumor groups and for ICCC-3 diagnostic groups stratified to (B) malignant tumors and (C) nonmalignant tumors. Abbreviations: AAPC, average annual percentage change; ICCC-3, International Classification of Childhood Cancer, Third Edition.
Figure 3.
Figure 3.
(A) Kaplan-Meier survival curves for each tumor group stratified per time period, (B) five-year observed survival with 95% confidence interval per time period for ICCC-3 diagnostic groups of malignant tumors, and (C) five-year observed survival with 95% confidence interval per time period for malignant astrocytomas and other gliomas. Abbreviation: ICCC-3, International Classification of Childhood Cancer, Third Edition.
Figure 4.
Figure 4.
Trends in incidence and mortality of patients diagnosed with a CNS tumor in the Netherlands. Abbreviation: AAPC, average annual percentage change.
See this image and copyright information in PMC

References

    1. Gatta G, Peris-Bonet R, Visser O, et al. . Geographical variability in survival of European children with central nervous system tumours. Eur J Cancer. 2017;82:137–148. - PubMed
    1. Steliarova-Foucher E, Fidler MM, Colombet M, et al. . Changing geographical patterns and trends in cancer incidence in children and adolescents in Europe, 1991-2010 (Automated Childhood Cancer Information System): a population-based study. Lancet Oncol. 2018;19(9):1159–1169. - PMC - PubMed
    1. Gatta G, Botta L, Rossi S, et al. . Childhood cancer survival in Europe 1999–2007: results of EUROCARE-5—a population-based study. Lancet Oncol. 2014;15(1):35–47. - PubMed
    1. Reedijk AMJ, Kremer LC, Visser O, et al. . Increasing incidence of cancer and stage migration towards advanced disease in children and young adolescents in the Netherlands, 1990-2017. Eur J Cancer. 2020;134:115–126. - PubMed
    1. Reedijk AM, Janssen-Heijnen ML, Louwman MW, et al. . Increasing incidence and improved survival of cancer in children and young adults in Southern Netherlands, 1973-1999. Eur J Cancer. 2005;41(5):760–769. - PubMed

LinkOut - more resources