Abstract
Background
Tumours of the central nervous system (CNS) represent a relatively rare but serious
health burden. This study provides insight into the incidence and survival patterns
of gliomas in the Netherlands diagnosed in adult patients during the time period 1989–2010,
with a focus on glioblastoma and low-grade gliomas.
Methods
Data on 21,085 gliomas (excluding grade I tumours) were obtained from the Netherlands
Cancer Registry, including tumours of the CNS without pathological confirmation. We
calculated the age-standardised incidence rates and the estimated annual percentage
change (EAPC) for all glioma subtypes. Crude and relative survival rates were estimated
using information on the vital status obtained from the Dutch Municipal Personal Records
Database.
Results
Incidence of gliomas in adults increased over time, from 4.9 per 100,000 in 1989 to
5.9 in 2010 (EAPC 0.7%, p < 0.001). Two thirds were astrocytoma, 10% oligodendroglioma/oligoastrocytoma, 3% ependymoma
and 21% were unspecified. Within the group of astrocytic tumours, the proportion of
glioblastoma rose, while the proportion of anaplastic and unspecified astrocytoma
decreased. Unspecified neoplasms also decreased, but this was significant only after
2005. Over the course of the study period, glioblastoma patients more often received
multimodality treatment with chemotherapy concomitant and adjuvant to radiotherapy.
The crude two-year survival rate of glioblastoma patients improved significantly,
from 5% in the time period 1989–1994 to 15% in 2006–2010, with median survival increasing
from 5.5 to 9 months. The incidence of low-grade gliomas did not change over time. Survival rates
for low-grade oligodendroglial and mixed tumours show a modest improvement.
Conclusions
The incidence rate for the total group of gliomas slightly increased, with a decrease
of anaplastic and unspecified tumours and an increase of glioblastoma. Following the
introduction of combined chemoradiation, two-year survival rates for glioblastoma
significantly improved. Survival improved for low-grade gliomas except for low-grade
astrocytic tumours.
Keywords
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References
Central Brain Tumor Registry of the United States. Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2004–2006; 2010.
- Annual report to the nation on the status of cancer, 1975–2007, featuring tumors of the brain and other nervous system.J Natl Cancer Inst. 2011; 103: 714-736
- Epidemiology of glial and non-glial brain tumours in Europe.Eur J Cancer. 2012; 48: 1532-1542
- Louis D.N. Ohgaki H. Wiestler O.D. Cavanee W.K. WHO classification of tumours of the central nervous system. 4th ed. IARC Press, Lyon2007
- Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma.N Engl J Med. 2005; 352: 987-996
- Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial.Lancet Oncol. 2009; 10: 459-466
- The dilemma of low grade glioma.J Neurol Neurosurg Psychiatry. 2004; 75: ii31-ii36
- Management of diffuse low-grade cerebral gliomas.Neurol Clin. 2010; 28: 1037-1059
- Diffusely infiltrative low-grade gliomas in adults.J Clin Oncol. 2006; 24: 1236-1245
- Outcome in adult low-grade glioma: the impact of prognostic factors and treatment.Neurology. 2007; 69: 1366-1373
- Suspected low-grade glioma: is deferring treatment safe?.Ann Neurol. 1992; 31: 431-436
- Cognitive status and quality of life in patients with suspected versus proven low-grade gliomas.Neurology. 2001; 56: 618-623
- Supratentorial low grade astrocytoma: prognostic factors, dedifferentiation, and the issue of early versus late surgery.J Neurol Neurosurg Psychiatry. 1998; 64: 581-587
- Current treatment of low grade gliomas.Memo. 2012; 5: 223-227
- Guidelines on management of low-grade gliomas: report of an EFNS-EANO Task Force.Eur J Neurol. 2010; 17: 1124-1133
- Comparison of a strategy favoring early surgical resection vs a strategy favoring watchful waiting in low-grade gliomas.JAMA. 2012; 308: 1881-1888
- Brain, other central nervous system, and eye cancer.Cancer. 1995; 75: 330-337
- The increasing incidence of malignant gliomas and primary central nervous system lymphoma in the elderly.Cancer. 1995; 76: 1634-1642
- The incidence of primary central nervous system neoplasms before and after computerized tomography availability.J Neurosurg. 1995; 83: 999-1003
- Incidental findings on brain magnetic resonance imaging: systematic review and meta-analysis.BMJ. 2009; 17: b3016
- Cancer surveillance series [corrected]: brain and other central nervous system cancers: recent trends in incidence and mortality.J Natl Cancer Inst. 1999; 91: 1382-1390
- Stable incidence of childhood and adult glioma in The Netherlands, 1989–2003.Acta Oncol. 2006; 45: 272-279
- Brain and other central nervous system tumors: rates, trends, and epidemiology.Curr Opin Oncol. 2001; 13: 160-166
- Trends in incidence of primary malignant brain tumors in USA, 1981–1990.Int J Epidemiol. 1995; 24: 1078-1085
- Trends in incidence of brain and central nervous system tumors in Norway, 1970–1999.Neuroepidemiology. 2004; 23: 101-109
- Incidence trends of adult primary intracerebral tumors in four Nordic countries.Int J Cancer. 2004; 108: 450-455
- Temporal trends in incidence of primary brain tumors in the United States, 1985–1999.Neuro Oncol. 2006; 8: 27-37
- Grading of gliomas: the road from eminence to evidence.J Neuropathol Exp Neurol. 2011; 70: 101-109
- Completeness of cancer registration in Limburg, The Netherlands.Int J Epidemiol. 1993; 22: 369-376
- General practitioners and completeness of cancer registry.J Epidemiol Community Health. 1990; 44: 121-124
- A uniform histological cluster scheme for ICD-O-coded primary central nervous system tumors.Neuroepidemiology. 1998; 17: 233-246
- Problem of immortal time bias in cohort studies: example using statins for preventing progression of diabetes.BMJ. 2010; 12: b5087
- The Austrian Brain Tumour Registry: a cooperative way to establish a population-based brain tumour registry.J Neurooncol. 2009; 95: 401-411
- Population-based studies on incidence, survival rates, and genetic alterations in astrocytic and oligodendroglial gliomas.J Neuropathol Exp Neurol. 2005; 64: 479-489
- MGMT gene silencing and benefit from temozolomide in glioblastoma.N Engl J Med. 2005; 352: 997-1003
- Temozolomide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial.Lancet Oncol. 2012; 13: 916-926
- Temozolomide chemotherapy alone versus radiotherapy alone for malignant astrocytoma in the elderly: the NOA-08 randomised, phase 3 trial.Lancet Oncol. 2012; 13: 707-715
- Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC brain tumor group study 26951.J Clin Oncol. 2013; 31: 344-350
- Epidermal growth factor receptor variant III status defines clinically distinct subtypes of glioblastoma.J Clin Oncol. 2007; 25: 2288-2294
- Molecular subclasses of high-grade glioma predict prognosis, delineate a pattern of disease progression, and resemble stages in neurogenesis.Cancer Cell. 2006; 9: 157-173
- Gene expression-based classification of malignant gliomas correlates better with survival than histological classification.Cancer Res. 2003; 63: 1602-1607
- Malignant astrocytic glioma: genetics, biology, and paths to treatment.Genes Dev. 2007; 21: 2683-2710
- The definition of primary and secondary glioblastoma.Clin Cancer Res. 2013; 19: 764-772
Article info
Publication history
Published online: June 24, 2014
Accepted:
May 21,
2014
Received in revised form:
May 21,
2014
Received:
January 27,
2014
Identification
Copyright
© 2014 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
