Introduction: Meningioma manifests rarely in children and epidemiological descriptions of pediatric meningioma are scarce. We used national database to examine potential factors of long-term survival in pediatric meningioma patients.
Methods: The Surveillance Epidemiology and End Results (SEER) database was queried for patients with history of pediatric meningioma. Univariate and multivariate survival analyses were conducted to determine the effects of clinical characteristics and treatments on overall survival.
Results: A total 308 patients diagnosed with pediatric meningioma between 1998 and 2014 were identified through the database. Average age at diagnosis was 12.46 years old (SD ± 5.03) and the population was 51.3% males. Of the total, 39.9% (n=123) of the patients received gross total resection of the tumor, 30.5% (n=94) received partial resection, and 29.6% (n=91) did not receive any therapeutic surgical treatment. Out of those who underwent surgery, 12.3% (n=38) also received additional radiation therapy, including 10.6% (n=13) of gross total resection cases and 26.6% (n=25) of partial resection cases. Meningioma was the primary cause of death for 4 patients; 14 patients died due to other causes. Estimated 3-year survival was 96.3%, 5-year survival was 93.4%, and 10-year survival was 90.3%. Covariate analysis showed that the malignant behavior code is a significant factor (HR: 1.33, 95% CI: 0.067-2.59, p= 0.03). Older age at diagnosis was a significant predictor of survival for patients who did not receive surgery (Hazard Ratio -0.21, 95% CI: -0.41—0.011, p=0.04). Tumor size, sex, race, histologic type, surgical modality and adjunct radiation therapy did not significantly alter the rate of survival.
Conclusions: Pediatric meningioma carries a good prognosis for long-term survival. Different treatment modalities do not seem to significantly alter survival, though samples are small. Older age at diagnosis is a significant predictor of survival in patients who did not receive surgery. Malignant behavior is a significant factor for shorter survival overall.
Patient Care: A long-term analysis for pediatric meningioma is scarce due to its rarity. This study, through analysis of the national cancer database, identifies possible factors/predictor of survival in pediatric meningioma. In our knowledge, this is the largest sample of pediatric meningioma patients analyzed for long-term survival.
Learning Objectives: Characterize the epidemiology of pediatric meningioma using SEER database
Estimate the 3-, 5-, and 10-year survival rate of pediatric meningioma
Understand factors associated with survival of pediatric patients with meningioma