Epidemiology of Pediatric Central Nervous System Tumors: Back to the future

Raoull Hoogendijk

    Research output: ThesisDoctoral thesis 2 (Research NOT UU / Graduation UU)

    3 Downloads (Pure)

    Abstract

    Pediatric central nervous system (CNS) tumors are the most common solid tumors in children and among the deadliest cancers in childhood. This thesis investigates the survival outcomes of children diagnosed with a CNS tumor and explores ways to enhance the clinical relevance of population-based data.

    The Past
    Using data from the Netherlands Cancer Registry (NCR) for the period 1990–2017, our research found improved five-year survival rates for malignant CNS tumors over time, though there were periods of decline due to changes in diagnostic and registration practices. Comparing data with Belgium highlighted how differences in CNS tumor registration impact survival statistics. These challenges in tumor registration were further explored in the context of international tumor classification systems and current coding practices. We found that differences in availability of diagnostic tools and registration practices significantly affects data accuracy and international comparability of incidence and survival outcomes.

    The Future
    To address these challenges, we developed a protocol to improve data quality and relevance of reported outcomes. By using the NCR data and implementing this protocol we reported significant sex survival differences in pediatric high-grade gliomas. Due to the implementation of our protocol we were able to pinpoint this survival difference to high-grade midline gliomas, one of the most aggressive CNS tumor types in children. Further research is needed to unravel the underlying mechanisms contributing to this difference. In another study, we analyzed over 15,000 European cases to understand survival patterns and disparities, we again implemented our protocol which enhanced clinical relevance and led to more accurate information to inform stakeholders.

    In summary, this thesis emphasizes the importance of accurate tumor classification, coding, and integration of cancer registry data to inform research, clinical practices, and policymaking.
    Original languageEnglish
    Awarding Institution
    • University Medical Center (UMC) Utrecht
    Supervisors/Advisors
    • Hoving, Eelco, Supervisor
    • Wesseling, Pieter, Supervisor
    • Karim-Kos, H E, Co-supervisor
    • van Vuurden, D G, Co-supervisor
    Award date2 Apr 2025
    Publisher
    Print ISBNs978-94-6522-008-6
    DOIs
    Publication statusPublished - 2 Apr 2025

    Keywords

    • Epidemiology
    • Brain tumors
    • Pediatrics
    • Survival
    • Incidence

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