Introduction: Glioblastoma Multiforme (GBM) remains a very rare tumor in the pediatric population. The description of these tumors is currently limited to case reports and small case series, precluding an understanding of their natural history and prognostic factors. There is paucity of data evaluating surgical outcomes following treatment of pediatric GBM. In this study, we have performed a population-based analysis of patients with pediatric GBMs to characterize patient outcomes and evaluate the efficacy of surgical resection and radiotherapy.
Methods: The Surveillance, Epidemiology, and End Results (SEER) database was utilized to identify pediatric patients with GBMs. Patient, tumor, and treatment characteristics were summarized and analyzed to identify prognostic factors for survival.
Results: A total of 466 patients met the inclusion criteria. The median age was 11.0 years, with males accounting for 57.51% of patients. The median tumor size was 5.0cm. The majority of patients underwent surgical resection (86.0%) and radiotherapy (73.22%). The median overall survival for all patients was 12.0 months, Table 1. Univariate analysis revealed that resection (13months vs biopsy: 8months, p<0.0001), gross total resection (18months vs. subtotal resection: 12 months, p=0.0005) and Radiotherapy (13months vs no-radiotherapy: 6months, p<0.0001) significantly affected survival, Table 2. Using multivariate analysis when controlling for age and gender, surgical resection (HR: 0.58; 95%CI 0.439, 0.767; p=0.0001) and radiotherapy (HR: 0.655; 95%CI 0.516, 0.832; p=0.0005) significantly increased survival, Table 3. However, when controlling for gross total resection, only the extent of resection (HR: 0.626; 95%CI 0.49, 0.80, p=0.0002) and not radiotherapy (HR: 0.831; 95%CI 0.621, 1.111; p=0.212) affected survival, Table 4.
Conclusions: In this study, pediatric GBM patients benefit significantly from surgery and radiotherapy. However, when receiving gross total resection, we found no benefit in survival time with adjuvant radiotherapy. Therefore, patients should be carefully evaluated to assess impact of treatment modalities on outcomes.
Patient Care: Patients should be carefully evaluated to assess impact of treatment modalities on outcomes.
Learning Objectives: In this study, pediatric GBM patients benefit significantly from surgery and radiotherapy. However, when receiving gross total resection, we found no benefit in survival time with adjuvant radiotherapy