- Email: [email protected]
Spanish survey of treatment recommendations for elderly patients with glioblastoma
abstracts
Annals of Oncology 411P
Spanish survey of treatment recommendations for elderly patients with glioblastoma
Background: Glioblastoma (GB) is the most common malignant CNS tumor. Incidence ingreases with age, peaking between 69 and 84 yers, and half of patients diagnosed have > 65 years. The question about how to treat these patients remains object of controversy. The purpose of this survey was to know the treatment recommendations for BG in academic Spanish hospitals. Methods: In 2018, surveys were e-mailed to all members of GEINO (Spanish Group for Neurooncology Reseach). The survey contained specific questions on the routine clinical practice regarding treatment recommendations for elderly patients with GB and anaplastic astrocytoma in different clinical situations: depending on ECOG, morbility, MGMT promoter methylation, age intervals (between 65-70 y, 70-80 y, >80 y). Response options were: a) Stupp regimen, b) Perry regimen, c) Radiation or TMZ depending on MGMT status and d) supportive care. Participants were also asked if they used MGMT status to select patients for Stupp or Perry regimen. Results: Twenty-six neuro-oncoligist from twenty-six hospitals completed the survey. Mean of hospital beds of the institutions were 833.19 (range 150-1500). Mean of hospital veds of the instituions were 833,19 (range 150-1500). Median number of new cases treated per year were 31 (range 8-80). In patients with ECOG 0-1 and between 65 and 70 years old, 80.8 % of participants would recommend treatment with Stupp regiment. For patients with ECOG 0-1 and between 70-80; 46.2 % recommenden Perry regimen in methylated (M) and unmethylated (UM) patients; 38.5 % recommended Stupp regimen in both. For with ECOG 0-1 and > 80 % yo, 46,2 % recommend Perry regimen in both M and UM; 3.8 % Stupp regimen; 15,4 % radiation or TMZ according to MGMT status. In patients with anaplastic astrocytoma aged 70-80 y, 46,2 % would recommend Perry regimen and 42,3 % Stupp regimen.
Table: 411P
Glioblastoma, age 70-80 (PS 0-1, minor comorbility) Glioblastoma, age >80 (PS 0-1, mior comorbility Glioblastoma, age 65-70 (PS 0-1, minor comorbility) Glioblastoma, no MGMT methylation 70-80 >80 65-70 Glioblastoma >65, PS > 2 Anaplastic astrocytoma 70-80 yo Anaplastic astrocytoma >80 Anaplastic astrocytoma 65-70
Most recommend treatment
Percentage of responders
Perry Stupp
46.2 % 38.5 %
Perry
46.2 %
Stupp
80.8 %
Stupp Perry Stupp
50 % 34.6 % 68.5 %
Stupp Perry
36.8 % 30.8 %
Perry Stupp
34.6 % 53.8 %
Conclusions: Our research demonstrates there is no uniform approach to the management of elderly patient with glioblastoma among academic neuro-oncologist. Legal entity responsible for the study: GEINO (Grupo Espa~ nol de Investigaci on en Neurooncologıa). Funding: Has not received any funding. Disclosure: M. Vaz Salgado: Advisory / Consultancy, Travel / Accommodation / Expenses: Pharmamar; Advisory / Consultancy: Lilly, Eisai y Celgene; Research grant / Funding (self): Pfizer. M.
v150 | CNS Tumours
Volume 30 | Supplement 5 | October 2019
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz243.021/5577788 by guest on 25 October 2019
Vaz Salgado1, A. Rodrıguez Sanchez2, I. Fernandez Perez3, T. Quintanar4, M.A. M. Navarro Martin5, M. Vieito Villar6, J.M. Cano7, S. Gonzalez8, S. Ros9, A. Herrero Iba~ nez10, M.A. Ivars11, M. Lloret12, M. Alonso13, I. Moya14, R. Luque15, M. Benavides16, omez18, J. Esteban Villarrubia1, J. Torres Jimenez1 M. Gutie´rrez Toribio17, J. Garcıa-G 1 Department of Oncologia Medica, Hospital Universitario Ramon y Cajal, Madrid, Spain, 2Oncology, Complejo Asistencial Universitario de Le on, Leon, Spain, 3 Department Oncologia Medica, CHUVI - Complejo Hospitalario Universitario de Vigo, 4 Vigo, Pontevedra, Spain, Department Oncologia Medica, Hospital General Universitario de Elche, Elche, Spain, 5Department Oncologia Medica, IBSAL - Instituto de Investigaci on Biome´dica de Salamanca, Salamanca, Spain, 6Medical Oncology Department, Vall d’Hebron University Hospital - Vall d’Hebron Institute of Oncology VHIO, Barcelona, Spain, 7Medical Oncology, Hospital General Ciudad Real, Ciudad Real, Ciudad Real, Spain, 8Oncology, Hospital Mutua de Terrassa, Terrassa, Spain, 9Oncology, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain, 10Oncology, Hospital Miguel Servet, Zaragoza, Spain, 11Oncology, Hospital Universitario Morales Meseguer, Murcia, Spain, 12Oncology, Hospital Universitario Insular de Gran Canaria, Las Palmas, Spain, 13 Oncology, Hospital Universitario Virgen del Rocıo, Seville, Spain, 14Oncology, H. General Catalunya Instituto Oncol ogico Dr Rosell, Barcelona, Spain, 15Service of Medical Oncology, Hospital Universitario Virgen de las Nieves, Granada, Spain, 16 Oncology, Universitario Regional Virgen de la Victoria, Malaga, Spain, 17Oncology, Hospital Universitario de Araba, Alava, Spain, 18Oncology, Complejo Hospitalario Universitario de Orense, Orense, Spain
abstracts
Annals of Oncology Vieito Villar: Travel / Accommodation / Expenses: Roche. R. Luque: Honoraria (self), Travel / Accommodation / Expenses: Janssen-Cilag; Honoraria (self), Travel / Accommodation / Expenses: Sanofi Aventis; Honoraria (self), Travel / Accommodation / Expenses: Astellas Medivation; Honoraria (self), Travel / Accommodation / Expenses: Roche; Honoraria (self), Travel / Accommodation / Expenses: Novartis; Honoraria (self), Travel / Accommodation / Expenses: Pfizer; Honoraria (self), Travel / Accommodation / Expenses: Bristol Mayers Squibb; Honoraria (self), Travel / Accommodation / Expenses: EUSA Pharma. All other authors have declared no conflicts of interest.
Legal entity responsible for the study: Sherief Ghozy. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
414P 412P
I. Ceballos Lenza1, P. Perez Segura2, M.A.V. Salgado3, S. del barco4, O. Gallego5, non9, R. de las Penas Bataller9 T. Quintanar6, M.A. Ivars7, I. Fernandez Perez8, F. Garcıa-Pi~ 1 Medical Oncology, Hospital Universitario de Canarias, San Cristobal De La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain, 2Medical Oncology, Hospital Clinico Universitario San Carlos, Madrid, Spain, 3Medical Oncology, Hospital Universitario Ramon y Cajal, Madrid, Spain, 4Medical Oncology, ICO Girona, Girona, Spain, 5Medical oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, 6Medical Oncology, Hospital General Universitario de Elche, Elche, Spain, 7Medical Oncology, Hospital Universitario Morales Meseguer, Murcia, Spain, 8Medical Oncology, CHUVI - Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain, 9Medical Oncology, Hospital Provincial Castellon, Castell on, Spain Background: The Spanish Research Group in Neuro-oncology (GEINO) and Spanish Infrequent and Orphan Tumors Group (GETHI) initiated a Nervous System Tumors Registry (RETSINE) in September 2017 with the aim of evaluating accurate, basic data concerning this oncological pathology in Spain. (Spanish Agency of Medicines and Medical Devices code: GG-TIN-2017-01). Methods: The RETSINE database collects demographic, diagnostic and treatment data from all the hospitals participating in the project. Secondarily, each researcher indicates if there is a tumor sample available for future studies that arise from the registry. Results: From September 2017 to April 2019, the registry has included 1021 patients (p) from 26 different hospitals. P have been included at a rate of 60 per month. With a median age of 60 y (range: 16-89), there is a discrete predominance in males (56.1%). The main symptoms at presentation are seizures, cognitive impairment and ataxia (26.1%, 16.8% and 6.6% of p). Histology provided in 841 p ¼ 764/841 glioma (90,8%) [High Grade Glioma 618/764 (80.9%), Low Grade Glioma 146/764 (19.1%)], 77/308 no glioma (9,2%). Primary surgical treatment¼ 42.4% total tumor removal; 38.9% subtotal tumor removal and 7.7% biopsy. The median overall survival is 18.1 m (95% CI 15.5-20.6): 115.6 m (95% CI 38.8-192.4) in Low Grade and 17.5 m (95% CI 15.4-19.5) in High Grade Glioma. Conclusions: RETSINE is a valuable tool for analyzing the current situation of Nervous System Tumors in Spain. The possibility of carrying out clinical studies in tumors of low incidence will be increased and improved with records of cases with associated biological sample. The database provides medical information that can also assist the orientation of healthcare policies. Legal entity responsible for the study: Spanish Research Group in Neuro-oncology (GEINO) and Spanish Infrequent and Orphan Tumors Group (GETHI). Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
S. Ghozy1, M. Dibas2, A.M. Afifi3, M. A. Hashim4, A.S. Abbas5, M. M. Abdel-Daim6 Neurosurgery Department, El Sheikh Zayed Specialized Hospital, Giza, Egypt, 2College Of Medicine, Sulaiman Al-Rajhi Colleges, Qassim, Saudi Arabia, 3Faculty of Medicine, Ain Shams University, Cairo, Egypt, 4Department of Cardiovascular Diseases, University of Kentucky, Lexington, KY, USA, 5Faculty of Medicine, Minia University, Minia, Egypt, 6 Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
1
Background: Primary cerebral lymphoma (PCL) is a rare malignancy representing less than 1.5% of brain tumors. Given the lack of studies in the literature that describe PCL, we used data from the Surveillance, Epidemiology, and End Results (SEER) database to investigate PCL’s prognostic factors, incidence and survival rates. Methods: We conducted a retrospective population-based cohort study using SEER database from 1983-2014. Patients with primary lymphoma as their only primary malignancy analyzed. Patients who were diagnosed by autopsy, had no active follow up in the registry and with unknown Ann Arbor Staging, or radiology status were excluded. We also calculated the frequencies and the average annual age-adjusted rate (AAR) of PCL patients between 2000 and 2015. Uni- and multivariable accelerated failure time regression were used to identify possible prognostic factors affecting the patient’s survival. Results: We identified 1,196 PCL cases, with an average age of diagnosis 56.71 6 17.28 years and 59.9% were males. Diffuse B-cell lymphoma was the most prevalent sub-type (61.3%). AAR was 0.14 per 100,000. These rates were higher in males, Asian or Pacific Islander and increasing with age. PCL-specific 1-year, 2-year, and 5-year survival rates were 89.6%, 84.4%, and 67%, respectively. Increased age (HR: 1.02, 95%CI¼1.01–1.03, P < 0.001) and recent diagnosis after 2002 (HR: 2.42, CI ¼ 1.46–3.42, P < 0.001) were significantly associated with shorter survival, while having a PCL in the temporal lobe (HR: 0.62, 95%CI¼0.40–0.98, P ¼ 0.040), or parietal lobe (HR: 0.63, 95%CI¼0.42– 0.94, P ¼ 0.024) as compared to the other sites, and receiving radiation (HR: 0.37, 95% CI ¼ 0.15–0.92, P ¼ 0.033) or chemotherapy (HR: 0.64, 95%CI¼0.50–0.83, P ¼ 0.001) were associated with improved survival. Conclusions: This is the first report to shed light on PCL’s incidence, survival rate, and prognostic factors. As a result, it will provide physicians and researchers with insights about this rare malignancy. Legal entity responsible for the study: Sherief Ghozy. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
415P
Trends in incidence and survival analyses of adult-onset medulloblastoma
F. Lin1, Q. Zhuang1, X. Lin1, X. Zhang1, Y. Huang1, L. Tang1, W. Junxin1, J. Li2 Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China, 2Radiation, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
1
413P
Development and validation of novel nomograms predicting survival of malignant ependymoma patients: A population-based study
A.S. Abbas1, M. Dibas2, S. Ghozy3 Faculty of Medicine, Minia University, Minia, Egypt, 2College Of Medicine, Sulaiman AlRajhi Colleges, Qassim, Saudi Arabia, 3Neurosurgery Department, El Sheikh Zayed Specialized Hospital, Giza, Egypt
1
Background: Malignant ependymomas are one of the main types of glioma that have high morbidity and mortality. The objective of this study was to construct, validate and calibrate novel nomograms for the survival of ME patients. Methods: We utilized the Surveillance, Epidemiology, and End Results database (SEER) to retrieve patients with ME. We excluded patients with an unknown diagnosis, no follow up or with autopsy report only. Moreover, we utilized penalized regression models (PRM) by using “hdnom” package in R with the highest AUC and the most stable calibrations to build nomograms for overall (OS) and cancer-specific survival (CSS). Results: Data of 3435 patients were retrieved and analyzed. We developed 18 PRM and chose Snet and SCAD for OS and CSS. These two models selected age, sex, year of diagnosis, marital status, site, race, type, surgery, radiation, and chemotherapy for the nomograms to be built. Our nomograms had stable calibrations with adequate to good accuracy AUC of 0.70 to 0.76 for the OS nomogram and AUC of 0.75 to 0.78 for the CSS nomogram. Conclusions: In this population-based study, we developed nomograms that can better help physicians predict the prognosis and survival of ME patients.
Volume 30 | Supplement 5 | October 2019
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)¼0.15). 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. aged40: 0.025 per 100,000). According to multivariable Cox analysis, age (P < 0.001) and surgical resection (P ¼ 0.002) were independently prognostic factors. Moreover, subgroup analysis showed that the benefits of radiotherapy (P ¼ 0.048) and chemotherapy (P ¼ 0.045) were observed in the patients without gross total resection (GTR). After propensity-score matching (n ¼ 582), factors impacting OS were age (P < 0.001), surgical resection (P ¼ 0.012), histology (P ¼ 0.031), insurance status (P ¼ 0.014) and marital status(P ¼ 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
doi:10.1093/annonc/mdz243 | v151
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Updated analysis of the national registry of nervous system tumours in Spain (RETSINE). RETSINE: National registry of nervous system tumours of the Spanish research group in neuro-oncology (GEINO) and Spanish infrequent and orphan tumours group (GETHI)
Characteristics, incidence, and survival of primary cerebral lymphoma: A population based study
Annals of Oncology 411P
Spanish survey of treatment recommendations for elderly patients with glioblastoma
Background: Glioblastoma (GB) is the most common malignant CNS tumor. Incidence ingreases with age, peaking between 69 and 84 yers, and half of patients diagnosed have > 65 years. The question about how to treat these patients remains object of controversy. The purpose of this survey was to know the treatment recommendations for BG in academic Spanish hospitals. Methods: In 2018, surveys were e-mailed to all members of GEINO (Spanish Group for Neurooncology Reseach). The survey contained specific questions on the routine clinical practice regarding treatment recommendations for elderly patients with GB and anaplastic astrocytoma in different clinical situations: depending on ECOG, morbility, MGMT promoter methylation, age intervals (between 65-70 y, 70-80 y, >80 y). Response options were: a) Stupp regimen, b) Perry regimen, c) Radiation or TMZ depending on MGMT status and d) supportive care. Participants were also asked if they used MGMT status to select patients for Stupp or Perry regimen. Results: Twenty-six neuro-oncoligist from twenty-six hospitals completed the survey. Mean of hospital beds of the institutions were 833.19 (range 150-1500). Mean of hospital veds of the instituions were 833,19 (range 150-1500). Median number of new cases treated per year were 31 (range 8-80). In patients with ECOG 0-1 and between 65 and 70 years old, 80.8 % of participants would recommend treatment with Stupp regiment. For patients with ECOG 0-1 and between 70-80; 46.2 % recommenden Perry regimen in methylated (M) and unmethylated (UM) patients; 38.5 % recommended Stupp regimen in both. For with ECOG 0-1 and > 80 % yo, 46,2 % recommend Perry regimen in both M and UM; 3.8 % Stupp regimen; 15,4 % radiation or TMZ according to MGMT status. In patients with anaplastic astrocytoma aged 70-80 y, 46,2 % would recommend Perry regimen and 42,3 % Stupp regimen.
Table: 411P
Glioblastoma, age 70-80 (PS 0-1, minor comorbility) Glioblastoma, age >80 (PS 0-1, mior comorbility Glioblastoma, age 65-70 (PS 0-1, minor comorbility) Glioblastoma, no MGMT methylation 70-80 >80 65-70 Glioblastoma >65, PS > 2 Anaplastic astrocytoma 70-80 yo Anaplastic astrocytoma >80 Anaplastic astrocytoma 65-70
Most recommend treatment
Percentage of responders
Perry Stupp
46.2 % 38.5 %
Perry
46.2 %
Stupp
80.8 %
Stupp Perry Stupp
50 % 34.6 % 68.5 %
Stupp Perry
36.8 % 30.8 %
Perry Stupp
34.6 % 53.8 %
Conclusions: Our research demonstrates there is no uniform approach to the management of elderly patient with glioblastoma among academic neuro-oncologist. Legal entity responsible for the study: GEINO (Grupo Espa~ nol de Investigaci on en Neurooncologıa). Funding: Has not received any funding. Disclosure: M. Vaz Salgado: Advisory / Consultancy, Travel / Accommodation / Expenses: Pharmamar; Advisory / Consultancy: Lilly, Eisai y Celgene; Research grant / Funding (self): Pfizer. M.
v150 | CNS Tumours
Volume 30 | Supplement 5 | October 2019
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz243.021/5577788 by guest on 25 October 2019
Vaz Salgado1, A. Rodrıguez Sanchez2, I. Fernandez Perez3, T. Quintanar4, M.A. M. Navarro Martin5, M. Vieito Villar6, J.M. Cano7, S. Gonzalez8, S. Ros9, A. Herrero Iba~ nez10, M.A. Ivars11, M. Lloret12, M. Alonso13, I. Moya14, R. Luque15, M. Benavides16, omez18, J. Esteban Villarrubia1, J. Torres Jimenez1 M. Gutie´rrez Toribio17, J. Garcıa-G 1 Department of Oncologia Medica, Hospital Universitario Ramon y Cajal, Madrid, Spain, 2Oncology, Complejo Asistencial Universitario de Le on, Leon, Spain, 3 Department Oncologia Medica, CHUVI - Complejo Hospitalario Universitario de Vigo, 4 Vigo, Pontevedra, Spain, Department Oncologia Medica, Hospital General Universitario de Elche, Elche, Spain, 5Department Oncologia Medica, IBSAL - Instituto de Investigaci on Biome´dica de Salamanca, Salamanca, Spain, 6Medical Oncology Department, Vall d’Hebron University Hospital - Vall d’Hebron Institute of Oncology VHIO, Barcelona, Spain, 7Medical Oncology, Hospital General Ciudad Real, Ciudad Real, Ciudad Real, Spain, 8Oncology, Hospital Mutua de Terrassa, Terrassa, Spain, 9Oncology, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain, 10Oncology, Hospital Miguel Servet, Zaragoza, Spain, 11Oncology, Hospital Universitario Morales Meseguer, Murcia, Spain, 12Oncology, Hospital Universitario Insular de Gran Canaria, Las Palmas, Spain, 13 Oncology, Hospital Universitario Virgen del Rocıo, Seville, Spain, 14Oncology, H. General Catalunya Instituto Oncol ogico Dr Rosell, Barcelona, Spain, 15Service of Medical Oncology, Hospital Universitario Virgen de las Nieves, Granada, Spain, 16 Oncology, Universitario Regional Virgen de la Victoria, Malaga, Spain, 17Oncology, Hospital Universitario de Araba, Alava, Spain, 18Oncology, Complejo Hospitalario Universitario de Orense, Orense, Spain
abstracts
Annals of Oncology Vieito Villar: Travel / Accommodation / Expenses: Roche. R. Luque: Honoraria (self), Travel / Accommodation / Expenses: Janssen-Cilag; Honoraria (self), Travel / Accommodation / Expenses: Sanofi Aventis; Honoraria (self), Travel / Accommodation / Expenses: Astellas Medivation; Honoraria (self), Travel / Accommodation / Expenses: Roche; Honoraria (self), Travel / Accommodation / Expenses: Novartis; Honoraria (self), Travel / Accommodation / Expenses: Pfizer; Honoraria (self), Travel / Accommodation / Expenses: Bristol Mayers Squibb; Honoraria (self), Travel / Accommodation / Expenses: EUSA Pharma. All other authors have declared no conflicts of interest.
Legal entity responsible for the study: Sherief Ghozy. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
414P 412P
I. Ceballos Lenza1, P. Perez Segura2, M.A.V. Salgado3, S. del barco4, O. Gallego5, non9, R. de las Penas Bataller9 T. Quintanar6, M.A. Ivars7, I. Fernandez Perez8, F. Garcıa-Pi~ 1 Medical Oncology, Hospital Universitario de Canarias, San Cristobal De La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain, 2Medical Oncology, Hospital Clinico Universitario San Carlos, Madrid, Spain, 3Medical Oncology, Hospital Universitario Ramon y Cajal, Madrid, Spain, 4Medical Oncology, ICO Girona, Girona, Spain, 5Medical oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, 6Medical Oncology, Hospital General Universitario de Elche, Elche, Spain, 7Medical Oncology, Hospital Universitario Morales Meseguer, Murcia, Spain, 8Medical Oncology, CHUVI - Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain, 9Medical Oncology, Hospital Provincial Castellon, Castell on, Spain Background: The Spanish Research Group in Neuro-oncology (GEINO) and Spanish Infrequent and Orphan Tumors Group (GETHI) initiated a Nervous System Tumors Registry (RETSINE) in September 2017 with the aim of evaluating accurate, basic data concerning this oncological pathology in Spain. (Spanish Agency of Medicines and Medical Devices code: GG-TIN-2017-01). Methods: The RETSINE database collects demographic, diagnostic and treatment data from all the hospitals participating in the project. Secondarily, each researcher indicates if there is a tumor sample available for future studies that arise from the registry. Results: From September 2017 to April 2019, the registry has included 1021 patients (p) from 26 different hospitals. P have been included at a rate of 60 per month. With a median age of 60 y (range: 16-89), there is a discrete predominance in males (56.1%). The main symptoms at presentation are seizures, cognitive impairment and ataxia (26.1%, 16.8% and 6.6% of p). Histology provided in 841 p ¼ 764/841 glioma (90,8%) [High Grade Glioma 618/764 (80.9%), Low Grade Glioma 146/764 (19.1%)], 77/308 no glioma (9,2%). Primary surgical treatment¼ 42.4% total tumor removal; 38.9% subtotal tumor removal and 7.7% biopsy. The median overall survival is 18.1 m (95% CI 15.5-20.6): 115.6 m (95% CI 38.8-192.4) in Low Grade and 17.5 m (95% CI 15.4-19.5) in High Grade Glioma. Conclusions: RETSINE is a valuable tool for analyzing the current situation of Nervous System Tumors in Spain. The possibility of carrying out clinical studies in tumors of low incidence will be increased and improved with records of cases with associated biological sample. The database provides medical information that can also assist the orientation of healthcare policies. Legal entity responsible for the study: Spanish Research Group in Neuro-oncology (GEINO) and Spanish Infrequent and Orphan Tumors Group (GETHI). Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
S. Ghozy1, M. Dibas2, A.M. Afifi3, M. A. Hashim4, A.S. Abbas5, M. M. Abdel-Daim6 Neurosurgery Department, El Sheikh Zayed Specialized Hospital, Giza, Egypt, 2College Of Medicine, Sulaiman Al-Rajhi Colleges, Qassim, Saudi Arabia, 3Faculty of Medicine, Ain Shams University, Cairo, Egypt, 4Department of Cardiovascular Diseases, University of Kentucky, Lexington, KY, USA, 5Faculty of Medicine, Minia University, Minia, Egypt, 6 Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
1
Background: Primary cerebral lymphoma (PCL) is a rare malignancy representing less than 1.5% of brain tumors. Given the lack of studies in the literature that describe PCL, we used data from the Surveillance, Epidemiology, and End Results (SEER) database to investigate PCL’s prognostic factors, incidence and survival rates. Methods: We conducted a retrospective population-based cohort study using SEER database from 1983-2014. Patients with primary lymphoma as their only primary malignancy analyzed. Patients who were diagnosed by autopsy, had no active follow up in the registry and with unknown Ann Arbor Staging, or radiology status were excluded. We also calculated the frequencies and the average annual age-adjusted rate (AAR) of PCL patients between 2000 and 2015. Uni- and multivariable accelerated failure time regression were used to identify possible prognostic factors affecting the patient’s survival. Results: We identified 1,196 PCL cases, with an average age of diagnosis 56.71 6 17.28 years and 59.9% were males. Diffuse B-cell lymphoma was the most prevalent sub-type (61.3%). AAR was 0.14 per 100,000. These rates were higher in males, Asian or Pacific Islander and increasing with age. PCL-specific 1-year, 2-year, and 5-year survival rates were 89.6%, 84.4%, and 67%, respectively. Increased age (HR: 1.02, 95%CI¼1.01–1.03, P < 0.001) and recent diagnosis after 2002 (HR: 2.42, CI ¼ 1.46–3.42, P < 0.001) were significantly associated with shorter survival, while having a PCL in the temporal lobe (HR: 0.62, 95%CI¼0.40–0.98, P ¼ 0.040), or parietal lobe (HR: 0.63, 95%CI¼0.42– 0.94, P ¼ 0.024) as compared to the other sites, and receiving radiation (HR: 0.37, 95% CI ¼ 0.15–0.92, P ¼ 0.033) or chemotherapy (HR: 0.64, 95%CI¼0.50–0.83, P ¼ 0.001) were associated with improved survival. Conclusions: This is the first report to shed light on PCL’s incidence, survival rate, and prognostic factors. As a result, it will provide physicians and researchers with insights about this rare malignancy. Legal entity responsible for the study: Sherief Ghozy. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
415P
Trends in incidence and survival analyses of adult-onset medulloblastoma
F. Lin1, Q. Zhuang1, X. Lin1, X. Zhang1, Y. Huang1, L. Tang1, W. Junxin1, J. Li2 Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China, 2Radiation, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
1
413P
Development and validation of novel nomograms predicting survival of malignant ependymoma patients: A population-based study
A.S. Abbas1, M. Dibas2, S. Ghozy3 Faculty of Medicine, Minia University, Minia, Egypt, 2College Of Medicine, Sulaiman AlRajhi Colleges, Qassim, Saudi Arabia, 3Neurosurgery Department, El Sheikh Zayed Specialized Hospital, Giza, Egypt
1
Background: Malignant ependymomas are one of the main types of glioma that have high morbidity and mortality. The objective of this study was to construct, validate and calibrate novel nomograms for the survival of ME patients. Methods: We utilized the Surveillance, Epidemiology, and End Results database (SEER) to retrieve patients with ME. We excluded patients with an unknown diagnosis, no follow up or with autopsy report only. Moreover, we utilized penalized regression models (PRM) by using “hdnom” package in R with the highest AUC and the most stable calibrations to build nomograms for overall (OS) and cancer-specific survival (CSS). Results: Data of 3435 patients were retrieved and analyzed. We developed 18 PRM and chose Snet and SCAD for OS and CSS. These two models selected age, sex, year of diagnosis, marital status, site, race, type, surgery, radiation, and chemotherapy for the nomograms to be built. Our nomograms had stable calibrations with adequate to good accuracy AUC of 0.70 to 0.76 for the OS nomogram and AUC of 0.75 to 0.78 for the CSS nomogram. Conclusions: In this population-based study, we developed nomograms that can better help physicians predict the prognosis and survival of ME patients.
Volume 30 | Supplement 5 | October 2019
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)¼0.15). 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. aged40: 0.025 per 100,000). According to multivariable Cox analysis, age (P < 0.001) and surgical resection (P ¼ 0.002) were independently prognostic factors. Moreover, subgroup analysis showed that the benefits of radiotherapy (P ¼ 0.048) and chemotherapy (P ¼ 0.045) were observed in the patients without gross total resection (GTR). After propensity-score matching (n ¼ 582), factors impacting OS were age (P < 0.001), surgical resection (P ¼ 0.012), histology (P ¼ 0.031), insurance status (P ¼ 0.014) and marital status(P ¼ 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
doi:10.1093/annonc/mdz243 | v151
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Updated analysis of the national registry of nervous system tumours in Spain (RETSINE). RETSINE: National registry of nervous system tumours of the Spanish research group in neuro-oncology (GEINO) and Spanish infrequent and orphan tumours group (GETHI)
Characteristics, incidence, and survival of primary cerebral lymphoma: A population based study