Global trends in survival from astrocytic tumours in adolescents and young adults: a systematic review
A partir d’une revue systématique de la littérature (20 articles), cette étude analyse l’évolution, au niveau mondial sur la période 1973-2009, de la survie des adolescents et jeunes adultes (âge : 15-39 ans) atteints d’une tumeur astrocytaire et analyse les disparités géographiques
Background : Brain tumours represent an important cause of cancer-related death in adolescents and young adults. Most are diagnosed in low-income and middle-income countries. We aimed to conduct the first systematic review of time trends and geographical variation in survival in this age group. Methods : We included observational studies describing population-based survival from astrocytic tumours in patients aged 15-39 years. We queried six electronic databases from database inception to 31 December 2019. This review is registered with PROSPERO, number CRD42018111981. Results : Among 5,640 retrieved records, 20 studies fulfilled the inclusion criteria. All but one study focused on high-income countries. Five-year survival from astrocytoma (broad morphology group) mostly varied between 48.0% and 71.0% (1973-2004), without clear trends or geographic differences. Adolescents with astrocytoma had better outcomes than young adults, but survival values were similar when non-malignant tumours were excluded. During 2002-2007, five-year survival for WHO grade I-II tumours was in the range 72.6-89.1% in England, Germany, and the US, but lower in South-Eastern Europe (59.0%). Five-year survival for anaplastic astrocytoma varied between 39.6% and 55.4% (2002-2007). Five-year survival from glioblastoma was in the range 14.2-23.1% (1991-2009). Conclusions : Survival from astrocytic tumours remained somewhat steady over time, with little change between 1973 and 2009. Survival disparities were difficult to examine, because nearly all the studies were conducted in affluent countries. Studies often adopted the International Classification of Childhood Cancer, which, however, did not allow to accurately describe variation in survival. Larger studies are warranted, including under-represented populations and providing more recent survival estimates.
JNCI Cancer Spectrum 2020