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Overview of the results of the Commission on Cancer's Central
Nervous System (CNS) Tumor Patient Care Evaluation Study
Herbert H. Engelhard III, Kimberly R. Porter, Andrew K.
Stewart, Jeffrey J. Olson
University of Illinois, Chicago, Chicago, IL,
American College of Surgeons, Chicago, IL, Emory University, Atlanta, GA.
E-mail: hhengel@uic.edu
Background.
From Jan. 1 - Dec. 31, 2000, extensive data on a large set of
patients diagnosed to have a primary neoplasm of the central nervous system (CNS) were collected in a comprehensive study conducted by the Commission on
Cancer of the American College of Surgeons.
The objectives of the study were to determine the demographics, symptoms and
signs, and current methods of diagnosis and treatment, for these patients.
The purpose of this presentation is to give an overview of the results of this
study.
Methods.
Questionnaires were sent to all U.S. hospitals having a
cancer registry.
Data were collected via electronic record submissions made directly to the
National Cancer Data Base and/or on scannable paper forms.
Eligible cases were selected based on the ICD-O-2 topography codes C70.0-C70.9
(meninges), C71.0-C71.9 (brain), C72.0-C72.9 (spinal cord, cranial nerves and
other parts of the CNS), and C75.1-C75.3 (pituitary, craniopharyngeal and pineal
glands).
Data were analyzed using SPSSł, a standard statistical software package.
Results.
604 U.S. hospitals contributed data on a total of 9672
patients.
50.9% were female and 49.1% were male.
Patients ranged in age from 1 to 104 years, with a mean age of 55.34
years.
95.6% of patients had intracranial tumors.
71.4% of patients were diagnosed and treated at the reporting hospital.
Only 46.2% of patients were found to have headache, which was nonetheless the
most common symptom, followed by weakness, difficulty with coordination and/or
balance, visual and/or speech disturbance, altered alertness, memory loss and
many other symptoms.
At least 85.4% of patients had an MRI of the brain done.
The frontal lobe was the most common tumor location (30.2%). Multiple tumors
were present in 8.9% of patients.
Glioblastoma was the most common histological type (30.2%), followed by
meningioma (14.2%).
Only 6.4% of patients participated in clinical protocols.
The surgical procedures analyzed were divided into open or stereotactic biopsy,
craniotomy (with or without image guidance), laminectomy for spinal cord tumors,
and cerebrospinal fluid shunting procedures.
Hemorrhage at the operative site occurred in 3.4% of patients (with or without
clinical significance) and infection was noted in 1.9%.
452 patients received radiosurgery.
BCNU wafers were implanted 227 times.
As expected, external beam radiation and /or chemo- therapy were given for
malignant tumors, and some residual benign tumors.
Conclusions.
This study is the largest comprehensive single-year study
of CNS tumor patients ever conducted.
Data from the study are deemed suitable for benchmarking, describing prevailing
patterns of care, and generating additional hypotheses for future studies.
Further analysis of this data should prove useful, as it is broken down
according to age, ethnicity and tumor histology.
Information related to tumor recurrence and patient survival will continue to be
tracked.
Copyright © 2004 American Association for Cancer Research.
All rights reserved.
Source: http://aacr04.agora.com/planner/displayabstract.asp?presentationid=1495
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