The Landscape of Prognostic Factors of Ganglioglioma. Results from the Surveillance, Epidemiology, and End Results Program Database

Introduction: Anaplastic gangliogliomas (aGG) are rare, slow-growing tumors often associated with seizure disorders. In previous studies, aGG has shown higher incidence in younger people and males, although the nature of the disease is poorly characterized. The purpose of this investigation is to determine prognostic factors related to aGG.

Methods: This investigation queried the Surveillance, Epidemiology, and End Results (SEER) for ganglioma cases. The SEER registries included in our study include 17 cancer registries between the years 2000-2020. Cases were identified using the International Classification of Diseases (ICD) for Oncology, Third Revision morphology codes (9385/3). Kaplan-Meier curves and Cox proportional hazards models were applied to analyze survival differences. P-values less than 0.05 were considered significant.

Results: 64 total patients were included in this study. The majority were male (n=47), White (n=40), and found on the meninges (n=19) and spinal cord (n=17). Majority had partial resection (n=38), radiation (n=38), and no chemotherapy (n=34). Univariable survival analysis showed that young adult patients had the best overall survival (OS) at 5-years (p=0.04) and 10-years (p=0.038). No surgery was the only independent risk factor associated with a hazard ratio (HR) of 1.88 (95% CI: 0.85–6.54, p=0.03) at 5-years and a HR of 1.79 (95% CI: 0.83–5.98, p=0.03) at 10-years OS. Multinomial logistic regression demonstrated that Blacks were less likely to receive radical surgery (HR: 9.20e-05, 95% CI: 5.09e-05–0.0001663, p < 0.0001).

Conclusion : Age and surgery are determining factors in ganglioma prognosis. Older age is correlated with higher mortality. Surgical therapy is warranted for aGG with no surgery leading to worse prognosis. Future research should be dedicated to elucidating best therapeutic sequences.