Survival Outcomes and Prognostic Factors for Pediatric Gliomas: A SEER Database Analysis

Introduction: Pediatric gliomas, representing approximately 30% of pediatric central nervous system (CNS) tumors, are the most prevalent type of brain tumor in children. While most pediatric gliomas undergo surgical resection, adjuvant therapies such as radiation and chemotherapy are often employed for high-grade malignancies. Understanding survival differences across glioma subtypes and identifying prognostic factors can inform precision medicine and enhance early diagnostic efforts.

Methods: We analyzed data from the SEER database for primary CNS tumors (C70.0-C72.9) diagnosed from 2000 to 2020 in patients aged 0-19 years. Recorded variables included patient demographics and treatment characteristics for histologically confirmed gliomas. Kaplan-Meier survival curves and log-rank tests were used to assess survival differences among subtypes. Multivariate Cox proportional hazards models, stratified by diagnosis year, were applied to identify independent prognostic factors, considering variables such as tumor location, age, sex, race/ethnicity, treatment modality, income level, and rural/urban status.

Results: A total of 7,432 pediatric glioma patients were included. Diagnoses comprised 55.6% pilocytic astrocytoma, 5.77% anaplastic astrocytoma, 13.5% unspecified astrocytoma, and 9.18% glioblastoma. Multivariate analysis identified independent protective factors, including unspecified astrocytoma diagnosis, chemotherapy, absence of radiation therapy, median income >$75k, age >10 years, and non-Hispanic white race (p < 0.005). In anaplastic astrocytoma, risk factors included Native American/Alaskan Native ethnicity and residence in populations < 250k (p < 0.01). For glioblastoma, significant risk factors were urban residence and age < 9 years (p < 0.01).

Conclusion : Our findings suggest that income, age, race, and rural/urban status are independent prognostic factors for overall survival in pediatric glioma patients. These insights could guide targeted interventions and personalized treatment approaches.