Analysis of the factors related to mortality in patients with primary brain and central nervous system tumors

Khaled Rahmani, Faramarz Allahdini, Namam Ali Azadi, Mohsen Sokunati, Abdorrahim Afkhamzadeh

DOI: 10.22122/cdj.v0i0.279

Abstract


BACKGROUND: The present study aimed to assess the factors associated with the mortality of patints with brain tumor surgery at Be’sat Hospital in Sanandaj, Kurdistan, Iran.

METHODS: In this prospectively cross-sectional study, 108 patients diagnosed with brain tumor and followed by a surgery during April to December of 2014 were recruited. Eighteen cases were excluded from the study due to lack of information about their treatment outcomes. Patients’ information including age, gender, tumor type, tumor location, type of treatment, and extent of resection was collected by a checklist. Clinical outcome of the patients in six months after surgery was determined through phone calling to patients. All analyses conducted in SPSS software using logistic regression.

RESULTS: Forty-seven (52.2%) of the studied subjects were women. The age of cases ranged from 3 to 83 years with total mean of 43.4 ± 21.9 years. In six months after treatment, 41 (45.6%) of the treated patients died. After excluding 9 children from final analysis and modeling the data by logistic regression, statistically significant associations were observed between death from central nervous system (CNS) tumor and male gender [odds ratio (OR): 5.25, 95% confidence interval (CI): 1.38–21.99], higher age (OR: 1.07, 95% CI: 1.02–1.13), partial vs. total resection (OR: 20.24, 95% CI: 1.21–337.51), and high malignant potential tumors (OR: 14.77, 95% CI: 4.85–45.02).

CONCLUSION: The results showed that both demographic (advanced age and male gender) and clinical factors (high malignant potential tumors and partial removal of tumor) related to the worse outcome in patients with primary CNS tumors during six months after surgery.


Keywords


Brain Neoplasms; Central Nervous System Neoplasms; Mortality; Risk Factors

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Ostrom QT, Gittleman H, Fulop J, Liu M, Blanda R, Kromer C, et al. CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2008-2012. Neuro Oncol 2015; 17(Suppl 4): iv1-iv62.

Ostrom QT, Gittleman H, Liao P, Rouse C, Chen Y, Dowling J, et al. CBTRUS statistical report: Primary brain and central nervous system tumors diagnosed in the United States in 2007-2011. Neuro Oncol 2014; 16(Suppl 4): iv1-63.

Louis ED, Mayer SA, Rowland LP. Merritt's neurology. Philadelphia, PA: Lippincott Williams & Wilkins; 2015.

Pessina F, Navarria P, Cozzi L, Ascolese AM, Maggi G, Rossi M, et al. Role of surgical resection in patients with single large brain metastases: Feasibility, morbidity, and local control evaluation. World Neurosurg 2016; 94: 6-12.

Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin 2016; 66(1): 7-30.

Jazayeri SB, Rahimi-Movaghar V, Shokraneh F, Saadat S, Ramezani R. Epidemiology of primary CNS tumors in Iran: A systematic review. Asian Pac J Cancer Prev 2013; 14(6): 3979-85.

Reihani Kermani H. An epidemiologic survey on brain tumors in Kerman from 1997 to 2001. Iran South Med J 2004; 7(1): 47-53. [In Persian].

Meshkini A, Fakhrju A, Fathi A. Prevalence of central nervous system tumors-a single center ten years study in Tabriz Imam Khomeini Hospital. Med J Tabriz Univ Med Sci 2010; 31(4): 76-86. [In Persian].

Duffner PK. Long-term effects of radiation therapy on cognitive and endocrine function in children with leukemia and brain tumors. Neurologist 2004; 10(6): 293-310.

Meeske KA, Nelson MB. The role of the long-term follow-up clinic in discovering new emerging late effects in adult survivors of childhood cancer. J Pediatr Oncol Nurs 2008; 25(4): 213-9.

Tonning O, I, Perrin S, Lundgren J, Hjorth L, Johanson A. Long-term cognitive sequelae after pediatric brain tumor related to medical risk factors, age, and sex. Pediatr Neurol 2014; 51(4): 515-21.

Moiyadi AV, Shetty PM. Perioperative outcomes following surgery for brain tumors: Objective assessment and risk factor evaluation. J Neurosci Rural Pract 2012; 3(1): 28-35.

Allahdini F, Afkhamzadeh A, Amirjamshidi A, Delpisheh A. Factors affecting the outcomes of patient's suffering from chronic subdural hematoma after surgery by burr-hole hole-drainage method; a cross sectional survey. Iran J Surg 2010; 18(3): 19-26. [In Persian].

Tian M, Zhu D, Chen D, Huo X, Ge J, Lu J, et al. Prognostic value of age in neurological cancer: An analysis of 22,393 cases from the SEER database. Tumour Biol 2015; 36(11): 8341-8.

Stark AM, van de Bergh J, Hedderich J, Mehdorn HM, Nabavi A. Glioblastoma: Clinical characteristics, prognostic factors and survival in 492 patients. Clin Neurol Neurosurg 2012; 114(7): 840-5.

Assem M, Sibenaller Z, Agarwal S, Al-Keilani MS, Alqudah MA, Ryken TC. Enhancing diagnosis, prognosis, and therapeutic outcome prediction of gliomas using genomics. OMICS 2012; 16(3): 113-22.

Gorlia T, Stupp R, Brandes AA, Rampling RR, Fumoleau P, Dittrich C, et al. New prognostic factors and calculators for outcome prediction in patients with recurrent glioblastoma: A pooled analysis of EORTC Brain Tumour Group phase I and II clinical

trials. Eur J Cancer 2012; 48(8): 1176-84.

Norden AD, Drappatz J, Wen PY, Claus EB. Survival among patients with primary central nervous system lymphoma, 1973-2004. J Neurooncol 2011; 101(3): 487-93.

Pulido JS, Vierkant RA, Olson JE, Abrey L, Schiff D, O'Neill BP. Racial differences in primary central nervous system lymphoma incidence and survival rates. Neuro Oncol 2009; 11(3): 318-22.

Villano JL, Koshy M, Shaikh H, Dolecek TA, McCarthy BJ. Age, gender, and racial differences in incidence and survival in primary CNS lymphoma. Br J Cancer 2011; 105(9): 1414-8.

Johnson DR, Sawyer AM, Meyers CA, O'Neill BP, Wefel JS. Early measures of cognitive function predict survival in patients with newly diagnosed glioblastoma. Neuro Oncol 2012; 14(6): 808-16.

Song JY, Kim JH, Cho YH, Kim CJ, Lee EJ. Treatment and outcomes for gangliogliomas: A single-center review of 16 patients. Brain Tumor Res Treat 2014; 2(2): 49-55.

Clark AJ, Sughrue ME, Ivan ME, Aranda D, Rutkowski MJ, Kane AJ, et al. Factors influencing overall survival rates for patients with pineocytoma. J Neurooncol 2010; 100(2): 255-60.

Chaichana KL, Jackson C, Patel A, Miller NR, Subramanian P, Lim M, et al. Predictors of visual outcome following surgical resection of medial sphenoid wing meningiomas. J Neurol Surg B Skull Base 2012; 73(5): 321-6.

Oszvald A, Guresir E, Setzer M, Vatter H, Senft C, Seifert V, et al. Glioblastoma therapy in the elderly and the importance of the extent of resection regardless of age. J Neurosurg 2012; 116(2): 357-64.

Davis FG, Freels S, Grutsch J, Barlas S, Brem S. Survival rates in patients with primary malignant brain tumors stratified by patient age and tumor histological type: An analysis based on Surveillance, Epidemiology, and End Results (SEER) data, 1973-1991. J Neurosurg 1998; 88(1): 1-10.

Modan B, Wagener DK, Feldman JJ, Rosenberg HM, Feinleib M. Increased mortality from brain tumors: A combined outcome of diagnostic technology and change of attitude toward the elderly. Am J Epidemiol 1992; 135(12): 1349-57.

Surawicz TS, Davis F, Freels S, Laws ER Jr, Menck HR. Brain tumor survival: Results from the National Cancer Data Base. J Neurooncol 1998; 40(2): 151-60.

Gatta G, Peris-Bonet R, Visser O, Stiller C, Marcos-Gragera R, Sanchez MJ, et al. Geographical variability in survival of European children with central nervous system tumours. Eur J Cancer 2017; 82: 137-48.

Patel S, Bhatnagar A, Wear C, Osiro S, Gabriel A,

Kimball D, et al. Are pediatric brain tumors on the rise in the USA? Significant incidence and survival findings from the SEER database analysis. Childs Nerv Syst 2014; 30(1): 147-54.

Woehrer A, Hackl M, Waldhor T, Weis S, Pichler J, Olschowski A, et al. Relative survival of patients with non-malignant central nervous system tumours: A descriptive study by the Austrian Brain Tumour Registry. Br J Cancer 2014; 110(2): 286-96.

Bhat AR, Wani MA, Kirmani AR, Ramzan AU. Histological-subtypes and anatomical location correlated in meningeal brain tumors (meningiomas).

J Neurosci Rural Pract 2014; 5(3): 244-9.

Jagannathan J, Kanter AS, Sheehan JP, Jane JA Jr, Laws ER Jr. Benign brain tumors: Sellar/parasellar tumors. Neurol Clin 2007; 25(4): 1231-49, xi.

Bagley JH, Babu R, Friedman AH, Adamson C. Improved survival in the largest national cohort of adults with cerebellar versus supratentorial low-grade astrocytomas. Neurosurg Focus 2013; 34(2): E7.

Tseng MY, Tseng JH, Merchant E. Comparison of effects of socioeconomic and geographic variations on survival for adults and children with glioma. J Neurosurg 2006; 105(4 Suppl): 297-305.


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