Introduction: Pediatric primary spinal cord tumors are rare, with little available data regarding incidence and outcomes. Specifically, the efficacy of external beam radiation (EBR) in these patients is difficult to determine due to the relative paucity of cases. The Surveillance Epidemiology and End Results database (SEER) allows for evaluation of the demographics and overall survival of patients with primary spinal cord tumors, particularly in regard to radiotherapy.
Methods: The SEER database was queried over 1975 to 2007 for patients less than age nineteen diagnosed with a primary spinal cord tumor. Histological diagnoses were grouped into pilocytic astrocytoma, other low-grade astrocytoma (fibrillary astrocytoma, NOS), ependymoma, and high-grade glioma. Patient demographics, were collected with tumor pathology, treatment with EBR, and overall survival.
Results: 330 cases of histologically confirmed primary pediatric spinal cord tumors were identified. Despite the advent of MRI, the age-adjusted incidence did not change over the thirty-year study window (0.09 cases/100,000). Incidence was slightly higher in males (57%). Overall 5-year relative survival was 76%. Pilocytic astrocytoma had the best survival (93%) compared to high-grade glioma (27%). 60% of children did not receive EBR, for whom the survival was 89% compared to only 54% for those that did require EBR. The difference in survival for children treated with EBR or not was, respectively, 75% vs 95% in pilocytic astrocytoma, and 75% vs 25% in high-grade glioma. In ependymoma and low-grade astrocytoma (excluding pilocytic), the 5-year relative survival was not significantly different in children receiving EBR from those that did not (approximately 82% vs 91%).
Conclusions: The survival for pediatric spinal pilocytic astrocytoma,
low-grade astrocytoma, and ependymoma is quite high, while the outcome for
spinal high-grade gliomas is similar to that for pediatric surpratentorial high-grade tumors. This data may be particularly useful for clinicians considering the use of EBR in this patient population.
Patient Care: Previously unavailable data regarding the 5-year mortality rates of pediatric primary spinal cord tumors, considering the use of external beam radiation.
Learning Objectives: To describe the incidence and survival for pediatric spinal cord tumors, considering the use of radiotherapy.