Factors associated with survival of central nervous system tumors in a population-based cancer registry.

Abstract

e14025 Background: Population-Based Cancer Registries (PBCRs) are a primary source of information on cancer incidence and survival within a specific region. The PBCR of Bucaramanga, Colombia, is part of the 460 PBCRs worldwide that provide high-quality cancer registry data to the International Agency for Research on Cancer (IARC) and the International Association of Cancer Registries (IACR). This study analyzes the sociodemographic and clinical factors associated with the survival of central nervous system tumors (CNS tumors) diagnosed between 2003 and 2017, using data collected by the Bucaramanga PBCR. Methods: A retrospective cohort study was conducted on CNS tumors registered in the Bucaramanga PBCR, Colombia. Five-year survival rates were estimated using the Kaplan-Meier method, and Cox proportional hazards models were used to identify factors associated with mortality, adjusting for demographic, clinical, and pathological variables. Results: A total of 1,126 records of patients with newly diagnosed CNS tumors were analyzed. The five-year survival rate following diagnosis was 60%. Lower survival was observed in males compared to females (50% vs. 65%; p < 0.001). Tumor anatomical location significantly influenced five-year survival; meningeal tumors showed a better prognosis compared to tumors located in the brain (80% vs. 40%; p < 0.001). Glioblastoma had the worst prognosis, with a five-year survival rate of 25%. In contrast, benign tumors, such as nerve sheath and choroid plexus tumors, had survival rates close to 100%. Factors associated with higher mortality risk included age ≥60 years (HR 1.9, 95% CI 1.49–2.50), male sex (HR 1.3, 95% CI 1.14–1.67), diagnosis of a malignant tumor (HR 5.7, 95% CI 4.28–7.71), histological presentation of glioblastoma (HR 9.6, 95% CI 6.78–13.7), indeterminate tumor type (HR 7.9, 95% CI 5.28–12.0), or astrocytoma (HR 4.14, 95% CI 2.85–6.01), as well as anaplastic/undifferentiated tumor grade (HR 7.46, 95% CI 5.43–10.23) or tumors derived from B cells (HR 7.86, 95% CI 3.86–15.98). Another factor studied was socioeconomic status: high-high (HR 1.19, 95% CI 0.67–2.12), low-high (HR 0.93, 95% CI 0.65–1.32). However, the relationship between socioeconomic status and survival was not statistically significant (p = 0.485). Conclusions: The survival of patients with CNS tumors is influenced by sociodemographic and clinical factors. Male sex and age over 60 years at diagnosis were associated with poorer survival, as were diagnoses of malignant, anaplastic/undifferentiated tumors and histological subtype glioblastoma. These findings underscore the need for early diagnostic strategies, timely treatment, and consideration of clinical and social factors in the prognosis of CNS tumors.