Abstract 5362
Background
Medulloblastoma (MB) is a rare central nervous system malignancy in adult. For its rarity, most previous studies are limited on patient populations and ascertainment bias. We aimed to explore the population-level trends in incidence and assess potential predictors of overall survival (OS).
Methods
We utilized the Surveillance, Epidemiology and End Results Program (SEER) database between 1973 and 2015, to estimate the epidemiological trends of adult MB in the United States. Propensity-score matching was used to balance potential selection biases and Cox proportional hazard modeling was used to determine predictors of OS.
Results
The age-adjusted incidence was stable in MB patients aged 20 years old and elder in total (annual percent change (APC)=0.15). The age-adjusted incidence rate in males was slightly higher than that in females (0.065 vs. 0.049 per 100,000). Compared to whites, the rate was nearly doubled to blacks (0.063 vs. 0.033 per 100,000). There was obvious differ between the younger group and the elder group (aged 20-39: 0.107 vs. aged≥40: 0.025 per 100,000). According to multivariable Cox analysis, age (P < 0.001) and surgical resection (P = 0.002) were independently prognostic factors. Moreover, subgroup analysis showed that the benefits of radiotherapy (P = 0.048) and chemotherapy (P = 0.045) were observed in the patients without gross total resection (GTR). After propensity-score matching (n = 582), factors impacting OS were age (P < 0.001), surgical resection (P = 0.012), histology (P = 0.031), insurance status (P = 0.014) and marital status(P = 0.040).
Conclusions
From the SEER database, race, gender and age disparities were found in incidence of adult MB patients. The survival analysis demonstrated the benefits of the GTR and younger patients. As for patients without GTR, radiotherapy and chemotherapy may improve the long-term survival.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Feifei, Lin.
Funding
The Fujian Province Natural Science Foundation (2017J01260), Joint Funds for the Innovation of Science and Technology, Fujian province (2017Y9074), and the Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education/Beijing (2017 Open Project-9).
Disclosure
All authors have declared no conflicts of interest.
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