Survival
Plotted survival curves (Figure 1) for pediatric brain tumors showed disparities in survival across racial/ethnic groups (p<0.001). Overall median survival for all pediatric brain and CNS tumors (Fig. 1A) was 53 months (95% CI, 50-55). Non-Hispanic whites had better survival (Fig. 1B) with a median of 62 months (95% CI, 59-65). The remaining three racial groups had a worse survival with non-Hispanic blacks having a median survival of 41 months (95% CI, 34-47) and Hispanics and “Other” racial/ethnic groups both experiencing a median survival of 40 months (Table 2). When stratified by histology, anaplastic astrocytoma and Glioblastomas had the worst survival (Fig. 1C) with an overall median survival of 14 months (95% CI, 13-15). There were statistically significant differences in survival by race/ethnicity within these histologic sub-types (p=0.0001) with Hispanics and non-Hispanic blacks having a worse survival than non-Hispanic whites and Other. Children diagnosed with diffuse astrocytoma (protoplasma, fibrillary) and Mixed glioma (Fig. 1D), had a good prognosis with an overall median survival of 89 months (95% CI, 80-98) with no statistically significant differences across racial/ethnic groups (p=0.2908).
Multivariate adjustment of the model also revealed non-Hispanic black [adjusted Hazard Ratio (aHR) 1.12(1.04-1.21)], Hispanic [aHR 1.25( 1.18- 1.31) ], and Other [aHR 1.22( 1.12- 1.32)] racial groups had a significantly increased hazard of death as compared to non-Hispanic whites (Table 3). Hispanics and “Other” had a slightly increased hazard of death than was found in the unadjusted model while non-Hispanic blacks had a significantly decreased 10-year hazard of death in the adjusted model as compared to the unadjusted model.
There was no statistical difference between each Yost quintile groups and the reference group with the 10-year hazard of death for each group being approximately the same as that of the reference group. Controlling for all other variables decreased the hazard of death associated with the tumor type except for anaplastic astrocytoma and glioblastoma tumor types which still had a significantly high hazard of death [aHR, 2.13(1.83-2.48)].