Global survival trends for brain tumors, by histology: Analysis of individual records for 67,776 children diagnosed in 61 countries during 2000-2014 (CONCORD-3)

Fabio Girardi; Veronica Di Carlo; Charles Stiller; Gemma Gatta; Ryan R Woods; Otto Visser; Brigitte Lacour; Thomas C Tucker; Michel P Coleman; Claudia Allemani; CONCORD Working Group

doi:10.1093/neuonc/noac232

Global survival trends for brain tumors, by histology: Analysis of individual records for 67,776 children diagnosed in 61 countries during 2000-2014 (CONCORD-3)

Neuro Oncol. 2023 Mar 14;25(3):593-606. doi: 10.1093/neuonc/noac232.

Authors

Fabio Girardi^{1

2

3}, Veronica Di Carlo¹, Charles Stiller⁴, Gemma Gatta⁵, Ryan R Woods⁶, Otto Visser⁷, Brigitte Lacour^{8

9}, Thomas C Tucker^{10

11}, Michel P Coleman^{1

2}, Claudia Allemani¹; CONCORD Working Group

Collaborators

CONCORD Working Group:
S Bouzbid, M Hamdi-Chérif, L Kara, K Meguenni, D Regagba, S Bayo, T Cheick Bougadari, S S Manraj, K Bendahhou, A Ladipo, O J Ogunbiyi, N I M Somdyala, M A Chaplin, F Moreno, G H Calabrano, S B Espinola, B Carballo Quintero, R Fita, W D Laspada, S G Ibañez, C A Lima, A Mafra Da Costa, P C F De Souza, J Chaves, C A Laporte, M P Curado, J C de Oliveira, C L A Veneziano, D B Veneziano, A B M Almeida, M R D O Latorre, M S Rebelo, M O Santos, G Azevedo E Silva, J C Galaz, M Aparicio Aravena, J Sanhueza Monsalve, D A Herrmann, S Vargas, V M Herrera, C J Uribe, L E Bravo, L S Garcia, N E Arias-Ortiz, D Morantes, D M Jurado, M C Yépez Chamorro, S Delgado, M Ramirez, Y H Galán Alvarez, P Torres, F Martínez-Reyes, L Jaramillo, R Quinto, J Castillo, M Mendoza, P Cueva, J G Yépez, B Bhakkan, J Deloumeaux, C Joachim, J Macni, R Carrillo, J Shalkow Klincovstein, R Rivera Gomez, P Perez, E Poquioma, G Tortolero-Luna, D Zavala, R Alonso, E Barrios, A Eckstrand, C Nikiforuk, R R Woods, G Noonan, D Turner, E Kumar, B Zhang, J J Dowden, G P Doyle, N Saint-Jacques, G Walsh, A Anam, P De, C A McClure, K A Vriends, C Bertrand, A V Ramanakumar, L Davis, S Kozie, T Freeman, J T George, R M Avila, D K O'Brien, A Holt, L Almon, S Kwong, C Morris, R Rycroft, L Mueller, C E Phillips, H Brown, B Cromartie, J Ruterbusch, A G Schwartz, G M Levin, B Wohler, R Bayakly, K C Ward, S L Gomez, M McKinley, R Cress, J Davis, B Hernandez, C J Johnson, B M Morawski, L P Ruppert, S Bentler, M E Charlton, B Huang, T C Tucker, D Deapen, L Liu, M C Hsieh, X C Wu, M Schwenn, K Stern, S T Gershman, R C Knowlton, G Alverson, T Weaver, J Desai, D B Rogers, J Jackson-Thompson, D Lemons, H J Zimmerman, M Hood, J Roberts-Johnson, W Hammond, J R Rees, K S Pawlish, A Stroup, C Key, C Wiggins, A R Kahn, M J Schymura, S Radhakrishnan, C Rao, L K Giljahn, R M Slocumb, C Dabbs, R E Espinoza, K G Aird, T Beran, J J Rubertone, S J Slack, J Oh, T A Janes, S M Schwartz, S C Chiodini, D M Hurley, M A Whiteside, S Rai, M A Williams, K Herget, C Sweeney, J Kachajian, M B Keitheri Cheteri, P Migliore Santiago, S E Blankenship, J L Conaway, R Borchers, R Malicki, J Espinoza, J Grandpre, H K Weir, R Wilson, B K Edwards, A Mariotto, C Rodriguez-Galindo, N Wang, L Yang, J S Chen, Y Zhou, Y T He, G H Song, X P Gu, D Mei, H J Mu, H M Ge, T H Wu, Y Y Li, D L Zhao, F Jin, J H Zhang, F D Zhu, Q Junhua, Y L Yang, C X Jiang, W Biao, J Wang, Q L Li, H Yi, X Zhou, J Dong, W Li, F X Fu, S Z Liu, J G Chen, J Zhu, Y H Li, Y Q Lu, M Fan, S Q Huang, G P Guo, H Zhaolai, K Wei, W Q Chen, W Wei, H Zeng, A V Demetriou, W K Mang, K C Ngan, A C Kataki, M Krishnatreya, P A Jayalekshmi, P Sebastian, P S George, A Mathew, A Nandakumar, R Malekzadeh, G Roshandel, L Keinan-Boker, B G Silverman, H Ito, Y Koyanagi, M Sato, F Tobori, I Nakata, N Teramoto, M Hattori, Y Kaizaki, F Moki, H Sugiyama, M Utada, M Nishimura, K Yoshida, K Kurosawa, Y Nemoto, H Narimatsu, M Sakaguchi, S Kanemura, M Naito, R Narisawa, I Miyashiro, K Nakata, D Mori, M Yoshitake, I Oki, N Fukushima, A Shibata, K Iwasa, C Ono, T Matsuda, O Nimri, K W Jung, Y J Won, E Alawadhi, A Elbasmi, A Ab Manan, F Adam, E Nansalmaa, U Tudev, C Ochir, A M Al Khater, M M El Mistiri, G H Lim, Y Y Teo, C J Chiang, W C Lee, R Buasom, S Sangrajrang, K Suwanrungruang, P Vatanasapt, K Daoprasert, D Pongnikorn, A Leklob, S Sangkitipaiboon, S L Geater, H Sriplung, O Ceylan, I Kög, O Dirican, T Köse, T Gurbuz, F E Karaşahin, D Turhan, U Aktaş, Y Halat, S Eser, C I Yakut, M Altinisik, Y Cavusoglu, A Türkköylü, N Üçüncü, M Hackl, A A Zborovskaya, O V Aleinikova, K Henau, L Van Eycken, T Y Atanasov, Z Valerianova, M Šekerija, L Dušek, M Zvolský, L Steinrud Mørch, H Storm, C Wessel Skovlund, K Innos, M Mägi, N Malila, K Seppä, J Jégu, M Velten, E Cornet, X Troussard, A M Bouvier, A V Guizard, V Bouvier, G Launoy, S Dabakuyo Yonli, M L Poillot, M Maynadié, M Mounier, L Vaconnet, A S Woronoff, M Daoulas, M Robaszkiewicz, J Clavel, C Poulalhon, E Desandes, B Lacour, I Baldi, B Amadeo, G Coureau, A Monnereau, S Orazio, M Audoin, T C D'Almeida, S Boyer, K Hammas, B Trétarre, M Colonna, P Delafosse, S Plouvier, A Cowppli-Bony, F Molinié, S Bara, O Ganry, B Lapôtre-Ledoux, L Daubisse-Marliac, N Bossard, Z Uhry, J Estève, R Stabenow, H Wilsdorf-Köhler, A Eberle, S Luttmann, I Löhden, A L Nennecke, J Kieschke, E Sirri, C Justenhoven, F Reinwald, B Holleczek, N Eisemann, A Katalinic, R A Asquez, V Kumar, E Petridou, E J Ólafsdóttir, L Tryggvadóttir, D E Murray, P M Walsh, H Sundseth, M Harney, G Mazzoleni, F Vittadello, E Coviello, F Cuccaro, R Galasso, G Sampietro, A Giacomin, M Magoni, A Ardizzone, A D'Argenzio, A A Di Prima, A Ippolito, A M Lavecchia, A Sutera Sardo, G Gola, P Ballotari, E Giacomazzi, S Ferretti, L Dal Maso, D Serraino, M V Celesia, R A Filiberti, F Pannozzo, A Melcarne, F Quarta, A Andreano, A G Russo, G Carrozzi, C Cirilli, L Cavalieri d'Oro, M Rognoni, M Fusco, M F Vitale, M Usala, R Cusimano, W Mazzucco, M Michiara, P Sgargi, L Boschetti, S Marguati, G Chiaranda, P Seghini, M M Maule, F Merletti, E Spata, R Tumino, P Mancuso, T Cassetti, R Sassatelli, F Falcini, S Giorgetti, A L Caiazzo, R Cavallo, D Piras, F Bella, A Madeddu, A C Fanetti, S Maspero, S Carone, A Mincuzzi, G Candela, T Scuderi, M A Gentilini, R Rizzello, S Rosso, A Caldarella, T Intrieri, F Bianconi, P Contiero, G Tagliabue, M Rugge, M Zorzi, S Beggiato, A Brustolin, G Gatta, R De Angelis, M Vicentini, R Zanetti, F Stracci, A Maurina, M Oniščuka, M Mousavi, L Steponaviciene, I Vincerževskienė, M J Azzopardi, N Calleja, S Siesling, O Visser, T B Johannesen, S Larønningen, M Trojanowski, P Macek, T Mierzwa, J Rachtan, A Rosińska, K Kępska, B Kościańska, K Barna, U Sulkowska, T Gebauer, J B Łapińska, J Wójcik-Tomaszewska, M Motnyk, A Patro, A Gos, K Sikorska, M Bielska-Lasota, J A Didkowska, U Wojciechowska, G Forjaz de Lacerda, R A Rego, B Carrito, A Pais, M J Bento, J Rodrigues, A Lourenço, A Mayer-da-Silva, D Coza, A I Todescu, M Y Valkov, L Gusenkova, O Lazarevich, O Prudnikova, D M Vjushkov, A Egorova, A Orlov, L V Pikalova, L D Zhuikova, J Adamcik, C Safaei Diba, V Zadnik, T Žagar, M De-La-Cruz, A Lopez-de-Munain, A Aleman, D Rojas, R J Chillarón, A I M Navarro, R Marcos-Gragera, M Puigdemont, M Rodríguez-Barranco, M J Sánchez Perez, P Franch Sureda, M Ramos Montserrat, M D Chirlaque López, A Sánchez Gil, E Ardanaz, M Guevara, A Cañete-Nieto, R Peris-Bonet, M Carulla, J Galceran, F Almela, C Sabater, S Khan, D Pettersson, P Dickman, K Staehelin, B Struchen, C Egger Hayoz, E Rapiti, R Schaffar, P Went, S M Mousavi, J-L Bulliard, M Maspoli-Conconi, C E Kuehni, S M Redmond, A Bordoni, L Ortelli, A Chiolero, I Konzelmann, S Rohrmann, M Wanner, J Broggio, J Rashbass, C Stiller, D Fitzpatrick, A Gavin, D S Morrison, C S Thomson, G Greene, D W Huws, M Grayson, H Rawcliffe, C Allemani, M P Coleman, V Di Carlo, F Girardi, M Matz, P Minicozzi, N Sanz, N Ssenyonga, D James, R Stephens, E Chalker, M Smith, J Gugusheff, H You, S Qin Li, S Dugdale, J Moore, S Philpot, R Pfeiffer, H Thomas, B Silva Ragaini, A J Venn, S M Evans, L Te Marvelde, V Savietto, R Trevithick, J Aitken, D Currow, C Fowler, C Lewis

Affiliations

¹ Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.
² Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.
³ Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
⁴ National Cancer Registration and Analysis Service, Public Health England, London, UK.
⁵ Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
⁶ BC Cancer, Vancouver, British Columbia, Canada.
⁷ Department of Registration, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
⁸ National Registry of Childhood Solid Tumors, Faculty of Medicine -Vandœuvre-lès-Nancy Cedex, France.
⁹ National Registry of Childhood Cancers, CRESS EQ7, UMR-S 1153, INSERM, Université de Paris, Paris, France.
¹⁰ Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA.
¹¹ Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, Kentucky, USA.

Abstract

Introduction: Tumors of the central nervous system are among the leading causes of cancer-related death in children. Population-based cancer survival reflects the overall effectiveness of a health care system in managing cancer. Inequity in access to care world-wide may result in survival disparities.

Methods: We considered children (0-14 years) diagnosed with a brain tumor during 2000-2014, regardless of tumor behavior. Data underwent a rigorous, three-phase quality control as part of CONCORD-3. We implemented a revised version of the International Classification of Childhood Cancer (third edition) to control for under-registration of non-malignant astrocytic tumors. We estimated net survival using the unbiased nonparametric Pohar Perme estimator.

Results: The study included 67,776 children. We estimated survival for 12 histology groups, each based on relevant ICD-O-3 codes. Age-standardized 5-year net survival for low-grade astrocytoma ranged between 84% and 100% world-wide during 2000-2014. In most countries, 5-year survival was 90% or more during 2000-2004, 2005-2009, and 2010-2014. Global variation in survival for medulloblastoma was much wider, with age-standardized 5-year net survival between 47% and 86% for children diagnosed during 2010-2014.

Conclusions: To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors in children, by histology. We devised an enhanced version of ICCC-3 to account for differences in cancer registration practices world-wide. Our findings may have public health implications, because low-grade glioma is 1 of the 6 index childhood cancers included by WHO in the Global Initiative for Childhood Cancer.

Keywords: brain tumor; cancer registries; childhood cancer; international comparisons; survival.

Publication types

Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Brain Neoplasms* / epidemiology
Child
Delivery of Health Care
Humans