C. Magnani et al., Variation in survival of children with central nervous system (CNS) malignancies diagnosed in Europe between 1978 and 1992: the EUROCARE study, EUR J CANC, 37(6), 2001, pp. 711-721
EUROCARE is a population-based survival study including data from European
Cancer Registries. The present paper analyses survival after a malignant ne
oplasm of the central nervous system (CNS) in childhood (aged 0-14 years at
diagnosis). The database includes 6130 cases from 34 population-based regi
stries in 17 countries: 1558 were primitive neuroectodermal tumours (PNET)
and 4087 astrocytoma, ependymoma or other gliomas: these morphologies were
grouped in the analyses in order to reduce the diagnostic variability among
the registries. 87% of cases were microscopically diagnosed (range among r
egistries 71-100%) and losses to follow-up were limited to 2% (range 0-14%)
. Actuarial analyses indicate that the European (weighted) average of 5 yea
rs cumulative survival for cases diagnosed in 1978-1989 was 53% (95% confid
ence interval (CI) 49-57) for CNS neoplasms, 44% (95% CI 37-50) for PNET an
d 60% (95% CI 55-65) for the glioma-related types. Analysis of the sub-set
of cases diagnosed in 1985-1989 revealed better results: cumulative surviva
l at 5 years was 61% (95% CI: 55-65) for all CNS neoplasms; 48% (95% CI 41-
56) for PNET and 68% (95% CI 62-73) for glioma-related types. Compared with
older children, infants showed poorer prognosis: in 1975-1989 the 5-year s
urvival rate was 33% (95% CI 23-45) and in 1985-1989 it was 46% (95% CI 34-
59). Variability among countries was very large, with 5-year survival for C
NS tumours diagnosed in 1985-1989 ranging from 28% in Estonia (95% CI 17-43
) to 73% Sweden (95% CI 59-83) and 75% in Iceland (95% CI 35-95) and 73% in
Finland (95% CI 66-79). Time trends were studied in a multivariate analysi
s observing a reduction in the risk of death in periods of diagnosis 1982-1
985 (hazard ratio (HR)=0.85; 95% CI 0.78-0.93) and 1986-1989 (HR=0.70; 95%
CI 0.64-0.77) compared with 1978-1981. The analysis were extended to 1990-1
992 for the countries whose registries provided data for that period did no
t indicate any further progress. Results of this study confirm the large va
riability in European countries and indicate a positive trend in the surviv
al probability for cases diagnosed in the 1980s, (C) 2001 Elsevier Science
Ltd. All rights reserved.