Does diagnostic delay result in decreased survival in paediatric brain tumours?
To study the hypothesis that a delay in the diagnosis of paediatric brain tumours results in decreased survival outcome probability, we compared the prediagnostic period of 315 brain tumour patients (median age 6.7 years, range, 0 to 16 years) with progression-free and overall survival. The median prediagnostic symptomatic interval was 60 days (range, 0 to 3,480 days), with a median parental delay of 14 days (range, 0 to 1,835 days) and a median doctor's delay of 14 days (range, 0 to 3,480 days). The prediagnostic symptomatic interval correlated significantly with the patient age, tumour histology, tumour location and year of diagnosis, but not with gender. We then grouped the patients according to histology (low-grade glioma [n=77], medulloblastoma [n=57], high-grade glioma [n=40], craniopharyngioma [n=27], ependymoma [n=20] and germ cell tumours [n=18]). Contrary to common belief, long prediagnostic symptomatic interval or long doctor's delay did not result in decreased survival outcome probability in any of these groups. The effect of tumour biology on survival seems to be dominant and overwhelms any possible opposing effect on survival of a delay in diagnosis.
Department of Oncology, University Children's Hospital of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
Karel
K
Kukal
Milana
M
Dobrovoljac
Eugen
E
Boltshauser
Roland A
RA
Ammann
Michael A
MA
Grotzer
D000293:Adolescent; D000367:Age Factors; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000175:diagnosis / Q000401:mortality; D055088:Early Detection of Cancer; D004806:Ependymoma / Q000175:diagnosis / Q000401:mortality; D005260:Female; D005910:Glioma / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008527:Medulloblastoma / Q000175:diagnosis / Q000401:mortality; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000401:mortality; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors