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Geographical variability in survival of European children with central nervous system tumours

2017; Elsevier BV; Volume: 82; Linguagem: Inglês

10.1016/j.ejca.2017.05.028

1879-0852

Gemma Gatta, Rafael Peris‐Bonet, Otto Visser, Charles Stiller, Rafael Marcos‐Gragera, María‐José Sánchez, B. Lacour, Peter Kaatsch, Franco Berrino, Stefan Rutkowski, Laura Botta, Monika Hackl, N. Zielonke, Willi Oberaigner, E. Van Eycken, K. Henau, Z. Valerianova, Nadya Dimitrova, Mario Šekerija, Hans H. Storm, Gerda Engholm, Margit Mägi, Tiiu Aareleid, Nea Malila, Karri Seppä, Jean Faivre, Nadine Bossard, Zoé Uhry, Marc Colonna, Jacqueline Clavel, Brigitte Lacour, Emmanuel Désandes, Hermann Brenner, Peter Kaatsch, Alexander Katalinic, Miklós Garami, Zsuzsanna Jakab, Harry Comber, Guido Mazzoleni, A. Bulatko, Carlotta Buzzoni, Adriano Giacomin, A. Sutera Sardo, Pamela Mancuso, Stefano Ferretti, A Barchielli, Adele Caldarella, Gemma Gatta, Milena Sant, H. Amash, C. Amati, Paolo Baili, Franco Berrino, S. Bonfarnuzzo, Laura Botta, Riccardo Capocaccia, F. Di Salvo, Roberto Foschi, C. Margutti, E. Meneghini, Pamela Minicozzi, Annalisa Trama, Diego Serraino, Antonella Zucchetto, Roberta De Angelis, M. Caldora, E. Carrani, Silvia Francisci, Sandra Mallone, Daniela Pierannunzio, P. Roazzi, Silvia Rossi, Mariano Santaquilani, Andrea Tavilla, Fabio Pannozzo, S. Busco, Rosangela Filiberti, Enza Marani, Paolo Ricci, Cristiana Pascucci, M. Autelitano, Gianbattista Spagnoli, Claudia Cirilli, Mario Fusco, Maria Francesca Vitale, M. Usala, Francesco Vitale, Barbara Ravazzolo, M. Michiara, Franco Merletti, Milena Maule, ­Rosario ­Tumino, Lucìa Mangone, E. Di Felice, Fabio Falcini, Antonio Iannelli, O. Sechi, R. Cesaraccio, Silvano Piffer, A Madeddu, F. Tisano, S. Maspero, Anna Clara Fanetti, P. Candela, T. Scuderi, Fabrizio Stracci, Fortunato Bianconi, Giovanna Tagliabue, Paolo Contiero, Massimo Rugge, Stefano Guzzinati, Santa Pildava, Giedrė Smailytė, Neville Calleja, D. Agius, Tom Børge Johannesen, Jadwiga Rachtan, Stanisław Góźdż, Ryszard Mężyk, Jerzy Błaszczyk, Marek Bębenek, Magdalena Bielska‐Lasota, G. Forjaz de Lacerda, María José Bento, Clara Castro, A. Miranda, A. Mayer-da-Silva, C. Safaei Diba, Maja Primic‐Žakelj, M. Errezola, J. Bidaurrazaga, ML Vicente Raneda, J.M. Díaz García, A.I. Marcos-Navarro, Rafael Marcos‐Gragera, À. Izquierdo, María‐José Sánchez, D.Y.L. Chang, Carmen Navarro, M.D. Chirlaque, Conchi Moreno‐Iribas, Eva Ardanáz, Rafael Peris‐Bonet, Elena Pardo Romaguera, Jaume Galcerán, M. Carulla, Mats Lambe, Seyed Mohsen Mousavi, Christine Bouchardy, M. Usel, S.M. Ess, H. Frick, Matthias Lorez, C. Herrmann, Andrea Bordoni, Alessandra Spitale, Isabelle Konzelmann, Otto Visser, Mieke J. Aarts, R. Otter, Michel P. Coleman, Claudia Allemani, Bernard Rachet, Julia Verne, Charles Stiller, Anna Gavin, David Donnelly, David Brewster,

Childhood Cancer Survivors' Quality of Life

Abstract Survival for childhood central nervous system (CNS) tumours varies across Europe, partly because of the difficulty of distinguishing malignant from non-malignant disease. This study examines bias in CNS tumours survival analysis to obtain the reliable and comparable survival figures. We analysed survival data for about 15,000 children (age <15) diagnosed with CNS between 2000 and 2007, from 71 population-based cancer registries in 27 countries. We selected high-quality data based on registry-specific data quality indicators and recorded observed 1-year and 5-year survival by countries and CNS entity. We provided age-adjusted survival and used a Cox model to calculate the hazard ratios (HRs) of death, adjusting by age, site and grading by country. Recording of non-malignant lesions, use of appropriate morphology codes and completeness of life status follow-up differed among registries. Five-year survival by countries varied less when non-malignant tumours were included, with rates between 79.5% and 42.8%. The HRs of dying, for registries with good data, adjusting by age and grading, were between 0.7 and 1.2; differences were similar when site (supra- and infra-tentorial) was included. Several sources of bias affect the correct definition of CNS tumours, the completeness of incidence series and the goodness of follow-up. The European Network of Cancer Registries needs to improve childhood cancer registration and stress the need to update the International Classification for Cancer. Since survival differences persisted even when restricting the analysis to registries with satisfactory data, and since diagnosis of CNS tumours is difficult and treatment complex, national plans must aim for the revision of the diagnosis and the coordination of care, with adequate national and international networks.