title: A national perspective of adult gangliogliomas.
abstract: Gangliogliomas (GG) are rare tumors of the nervous system. Patient characteristics and clinical outcomes of low and high-grade GG have been difficult to elucidate in the adult population. This study aims to further elaborate on GG treatment and overall survival utilizing a larger cohort than previously published. The USA National Cancer Database was utilized to evaluate adult (age 18years and older) patients diagnosed with GG between 2004 and 2006. Descriptive statistics and Kaplan-Meier overall survival estimates were provided. A total of 198 adult GG patients were diagnosed between 2004 and 2006. Of these, 181 (91.4%) were low-grade and 17 (8.6%) high-grade GG. Overall, the median age was 36years; approximately 50% of patients were female, and 86.5% Caucasian. Most patients (59%) had near/gross total resection. Radiation and chemotherapy were prescribed in 18 (9.1%) and 11 (5.7%) patients, respectively. Radiation (64.7% versus 3.9%, p<.0001) and chemotherapy (47.1% versus 1.7%, p<.0001) were more frequently given to patients with high-grade tumors than low-grade. The median overall survival of high-grade GG was 44.4months (95% confidence interval [CI]: 10.5-92.5) while the corresponding estimate for low-grade tumors was not reached. Older age (hazard ratio [HR] 1.72, 95% CI: 1.26-2.34) and high tumor grade (HR 3.91, 95% CI: 1.43-10.8) were found to be associated with poor survival. Adult GG have a temporal lobe predilection and overall gross total resection rate of 59%. Older patients with high-grade tumors had an increased hazard of mortality. High-grade GG were significantly more likely to be treated with radiation therapy and chemotherapy.
authors.affiliation: Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute, Department of Neurosurgery, Cedars-Sinai Medical Center, Advanced Health Sciences Pavilion, 127 S. San Vicente Boulevard, Suite A6600, Los Angeles, CA 90048, USA.
authors.forename: Kunal
authors.initials: K
authors.lastname: Varshneya
authors.affiliation: Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute, Department of Neurosurgery, Cedars-Sinai Medical Center, Advanced Health Sciences Pavilion, 127 S. San Vicente Boulevard, Suite A6600, Los Angeles, CA 90048, USA.
authors.forename: J Manuel
authors.initials: JM
authors.lastname: Sarmiento
authors.affiliation: Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute, Department of Neurosurgery, Cedars-Sinai Medical Center, Advanced Health Sciences Pavilion, 127 S. San Vicente Boulevard, Suite A6600, Los Angeles, CA 90048, USA.
authors.forename: Miriam
authors.initials: M
authors.lastname: Nuño
authors.affiliation: Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute, Department of Neurosurgery, Cedars-Sinai Medical Center, Advanced Health Sciences Pavilion, 127 S. San Vicente Boulevard, Suite A6600, Los Angeles, CA 90048, USA.
authors.forename: Carlito
authors.initials: C
authors.lastname: Lagman
authors.affiliation: Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute, Department of Neurosurgery, Cedars-Sinai Medical Center, Advanced Health Sciences Pavilion, 127 S. San Vicente Boulevard, Suite A6600, Los Angeles, CA 90048, USA.
authors.forename: Debraj
authors.initials: D
authors.lastname: Mukherjee
authors.affiliation: Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute, Department of Neurosurgery, Cedars-Sinai Medical Center, Advanced Health Sciences Pavilion, 127 S. San Vicente Boulevard, Suite A6600, Los Angeles, CA 90048, USA.
authors.forename: Karla
authors.initials: K
authors.lastname: Nuño
authors.affiliation: Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute, Department of Neurosurgery, Cedars-Sinai Medical Center, Advanced Health Sciences Pavilion, 127 S. San Vicente Boulevard, Suite A6600, Los Angeles, CA 90048, USA.
authors.forename: Harish
authors.initials: H
authors.lastname: Babu
authors.affiliation: Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute, Department of Neurosurgery, Cedars-Sinai Medical Center, Advanced Health Sciences Pavilion, 127 S. San Vicente Boulevard, Suite A6600, Los Angeles, CA 90048, USA. Electronic address: chirag.patil@cshs.org.
authors.forename: Chirag G
authors.initials: CG
authors.lastname: Patil
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D018303:Ganglioglioma / Q000453:epidemiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D013702:Temporal Lobe / Q000473:pathology*; D055815:Young Adult
keywords: Chemotherapy; Extent of resection; Ganglioglioma; Gross-total resection; Overall survival; Radiation