bluuebunny/crossref_metadata_2025_split huggingface dataset:
EPID-02. HEIGHT AND THE RISK OF MENINGIOMA
Authors: Yust-Katz Shlomit , Amiel Alexandra , Abu Shkara Ramiz , Siegal Tali , Twig Gilad 
Published: November 2019

Abstract

BACKGROUND
Meningiomas are the most common primary central nervous system tumors. Risk factors for meningiomas including obesity, height, history of allergy/atopy or autoimmune diseases, have been previously assessed with conflicting results. We reviewed a large cohort of Israeli adolescents in order to assess potential risk factors for the development of meningiomas.

METHODS
This study analyzed a cohort of 2,035,915 Jewish men and women who underwent obligatory physical examination when aged 16 to 19 years, from 1967 to 2011. Meningioma incidence was identified by linkage to the national cancer registry. Cox proportional hazard models were used to estimate the hazard ratios for meningioma according to sex, body mass index (BMI), height, history of allergic and autoimmune disease.

RESULTS
Linkage of the adolescent military database with the Israeli cancer registry identified 480 cases (152 males and 328 females) of meningioma during a follow up of 40,304,078-person years. The median age at diagnosis of meningioma was 42.1 ± 9.4 (range 17.4–62.6). On univariate analysis, only female gender (p< 0.01) and height (p< 0.01) were associated with risk for meningioma in the total study population. When stratified by gender, height remained a significant risk factor only in men. Spline analysis in the men group showed the minimum risk at a height of 1.62 meters and a statistically significant increase in the risk for meningioma at heights taller than 1.85 meters. BMI, past medical history including asthma, diabetes, and atopic and autoimmune diseases, were not associated with meningioma risk.

CONCLUSION
in this large population study, we found that sex and taller height in adolescent males was associated with an increased risk of adult meningioma.
EPID-08. TYPES OF BRAIN CANCER IN THE CENTRAL TEXAS MILITARY POPULATION
Authors: Murillo Jennifer , Brahmaroutu Ankita , Chen Wencong , Benge Jared , Fonkem Ekokobe 
Published: November 2019

Abstract

Multiple studies have demonstrated a correlation with military service and brain tumors, both for primary tumors and meningiomas. However, there is little comprehensive research on tumor types in the US military population. We evaluated our local brain tumor bank to identify types and correlates of brain tumors in a military vs. civilian population in central Texas.

PURPOSE
The purpose of our research was to describe brain cancers in the military population when compared to nonmilitary population in our local database.

METHODS
Retrospective data was derived from our brain tumor bank at the Baylor Scott & White in central Texas. Tumors were classified based on final histologically confirmed diagnosis when possible. Demographics and correlates. We obtained military background by chart review of notes, occupation, insurance provider and relationship to insured in the electronic medical record.

RESULTS
Data from 53 veterans and 170 non-veterans were analyzed. The most common tumor type in Veterans was glioblastoma multiforme (20.75%) followed by metastatic lesions (18.87%), meningiomas (16.98%) and adenomas (13.21%). There was no statistically significant difference in distribution of tumor types between civilians and controls. Demographic analysis revealed an older age of diagnosis in Veterans than civilians for the top three most common tumor types with glioblastoma multiforme (67.64 vs 61.65) with a difference of 5.99 years; metastatic lesions (69.4 vs 61.22) with a difference of 8.18 years and meningiomas (63.88 vs 57.57) with a difference of 6.31 years. (military versus civilians average age, respectively).

CONCLUSION
The age of onset for the three most common types of tumors were older in the Veteran population than civilians by an average of 6.82 years. More research into the older age of diagnosis for the Veterans should be further explored. Our research did not find any correlation between military service and tumor types as previous studies have shown.
EPID-14. OCCURRENCE OF SYSTEMIC CANCER IN PATIENTS WITH OLIGODENDROGLIOMAS: POPULATION CHARACTERIZATION AND COMPLICATIONS
Authors: Horta Erika , Snyder James , Walbert Tobias 
Published: November 2019

Abstract
Following clinic observations of patients with the diagnosis of oligodendroglioma and a systemic cancer, a chart review was done to understand the possible complications that a systemic cancer might bring to the treatment of the patient. Inclusion criteria was histological diagnosis of diffuse or anaplastic oligodendroglioma and another non-skin systemic cancer. Exclusion criteria was the diagnosis of genetic syndrome that predispose tumorigenesis. A total of 12 patients and 13 cancers were identified. 1p19q co-delection information was available for all patients except for 2. The most common systemic cancers were breast (46%) and gynecological cancers (16%). Different from CBTRUS data, men were underrepresented, being 31% of the patients, but difference did not reach statistical significance (p =0.08). Regarding age, patients were older than expected (53 + 12 years old, p< 0.0001). Systemic cancer was diagnosed after the oligodendroglioma diagnosis in 54% of the cases. Age at the diagnosis of systemic cancer was 54 + 10 years old. All patients are alive, except for two. Thromboembolism was seen in 25% of the patients (p=0.2 when comparing with literature for oligodendroglioma), and occurred always after the oligodendroglioma diagnosis. Thrombocytopenia was not associated to prior chemotherapy. No deviation of glioma treatment was seen. This chart review of patients with Oligodendroglioma and a systemic cancer identifies that this population is older than expected and thromboembolism rates are similar to the literature. The overrepresentation of women in this cohort represents the profile of systemic cancer that accompanied oligodendrogliomas. It is unclear why breast and other gynecological cancers were the most common. Further studies, likely multicentric due to the rarity of this diagnosis, as further research in large repository data should be performed to confirm this finding.
EPID-16. COMPARATIVE ANALYSIS OF OVERALL SURVIVAL AND ADVERSE EVENTS BY ADJUVANT TREATMENT MODALITIES IN ELDERLY PATIENTS WITH GLIOBLASTOMA USING THE SEER-MEDICARE DATABASE
Authors: Zhu Ping , Du Xianglin , Zhu Jay-Jiguang 
Published: November 2019

Abstract

OBJECTIVES
Few studies have investigated the frequency of adverse event (AE) by adjuvant therapy modalities in elderly patients with glioblastoma (GBM) in “real-world” setting. We conducted a retrospective cohort analysis to compare survival differences and incidences of AE with different treatment modalities.

METHODS
A total of 3100 elderly GBM patients were derived from the Surveillance, Epidemiology and End Results (SEER)-Medicare dataset (2004–2013). Adjuvant therapy modalities were either chemoradiation (CRT) followed by maintenance chemotherapy with temozolomide or RT alone. Primary outcomes include overall survival (OS) and cumulative incidences of 6-month and 1-year AEs with adjuvant therapies. Kaplan-Meier method and Cox proportional hazards regression were applied for survival analysis. Fine-Gray competing risk models were performed to estimate the risk of incident AEs over time with death as the competing risk event.

RESULTS
Superior OS was observed among GBM patients treated with CRT compared to RT alone (median OS: 6.9 vs. 2.9 months, P< 0.001). In multivariable Cox proportional hazard model, the risk of death was decreased by 52% for patients in the CRT group over the RT alone group (P< 0.001). Based on the multivariable competing risk models, the receipt of CRT was associated with higher risk of incident 6-month AEs with nausea/vomiting [sub-hazard ratio (SHR): 1.82, P=0.003] and constipation (SHR: 1.47, P=0.022); and 1-year AEs with neutropenia (SHR: 1.63, P=0.002), anemia (SHR: 1.64, P< 0.002), DVT (SHR: 1.25, P=0.035), seizure/epilepsy (SHR: 1.47, P=0.001), nausea/vomiting (SHR: 2.08, P< 0.001), diarrhea (SHR: 1.70, P=0.034), gastroenteritis/colitis (SHR: 2.77, P=0.024), constipation (SHR: 1.62, P=0.001), and dehydration (SHR: 1.27, P=0.020).

CONCLUSION
Comparing to the RT alone group, elderly GBM patients received CRT had 4-month median OS benefit, but experienced significantly higher incidences of AEs.
EPID-17. ANALYSIS OF THE USE OF BEVACIZUMAB FOR THE TREATMENT OF GLIOBLASTOMA IN THE UNITED STATES
Authors: Garcia Catherine , Chitwood Holly , Harwood Christopher , Shelton Brent , Morgan Rachael , Vermuelen Lee , Villano John 
Published: November 2019

Abstract

INTRODUCTION
Bevacizumab is an antibody against vascular endothelial growth factor that has been well investigated for glioblastoma, however, has limited proven efficacy. The drug has, however, demonstrated survival benefit in non-small cell lung carcinoma, renal cell carcinoma and colorectal carcinoma. We provide an overview of its use in the United States for select cancers.

METHODS
We queried the IQVIA database for all cases of glioblastoma diagnosed between January 2014 and June 2018 to analyze the use of bevacizumab for glioblastoma, non-small cell lung carcinoma, and colorectal carcinoma in the United States, and was compared to the standard of care for each indication (temozolomide for glioblastoma, pemetrexed for non-small cell lung carcinoma, and oxaliplatin for colorectal carcinoma).

RESULTS
A total of 85,351 patients were treated for glioblastoma as captured by IQVIA. Bevacizumab was prescribed in 17,958 patients, with a projected median annual total of 3,718 patients. The use of bevacizumab for glioblastoma during the study period decreased from 2014 to 2018 (p< 0.0001). The use of temozolomide has remained stable since 2014 to 2018 (p=0.49). For non-small cell lung cancer, we saw a significant decrease in the use of both bevacizumab and pemetrexed (p< 0.0001), with bevacizumab being used in less than 2% of the cases since 2017. For colorectal carcinoma, the use of bevacizumab has overall decreased with a peak use in 2016 (p< 0.0001). The use of oxaliplatin has increased (p< 0.0001).

CONCLUSIONS
Our findings demonstrated a decreased use of bevacizumab in oncology for three indications, likely associated with a changing role due to the benefit of novel therapy such as immunotherapy. The use of bevacizumab has decreased in glioblastoma, that may be associated to the lack of overall survival benefits in randomized clinical trials.
EPID-21. THE NATIONAL SPECTRUM OF NEWLY-DIAGNOSED BRAIN TUMORS IN ADULT PATIENTS VARIES SIGNIFICANTLY BY PATIENT DEMOGRAPHICS
Authors: Torre Matthew , Ascha Mustafa , Harary Maya , Smith Timothy , Aizer Ayal , Ligon Keith , Reardon David , Barnholtz-Sloan Jill , Iorgulescu Bryan 
Published: November 2019

Abstract

INTRODUCTION
Herein we examine the epidemiology and outcomes of the entire spectrum of intracranial tumors in the contemporary era.

METHODS
Adult patients (≥20yo) presenting between 2010–2015 where the first evidence of cancer involves an intracranial tumor were queried from the National Cancer Database, which comprises >70% of cancers newly-diagnosed in the U.S. Tumor types were classified by WHO2016 ICD-O3, and stratified by patient characteristics.

RESULTS
361,841 adults without a history of cancer presented with intracranial tumors between 2010–2015. Across all ages, these were comprised of 1) brain metastases (BMs; 25%: 29% in males vs. 23% in females); 2) meningiomas (25%: 15% in males, but 34% in females) including atypical (n=4,565) and anaplastic (n=833); 3) diffuse infiltrative gliomas (21%: 26% in males vs. 17% in females), mostly GBMs (14%); followed by 4) sellar (14%), 5) cranial nerve (6%), and PCNSL (3%) tumors. The remaining types each comprised ≤2 % of brain tumors, including mesenchymal non-meningothelial tumors (2%), intracranial ependymal (0.8%), mixed neuronal-glial (0.7%), circumscribed “other astrocytomas” (0.6%, mostly pilocytic astrocytomas n=1,307 and PXAs n=272), CNS embryonal (0.3%), pineal (0.2%), GCTs (0.1%), and choroid plexus (0.1%) tumors. In the 91,686 patients presenting with a BM, the most common primaries were lung adenocarcinoma (39%), lung SmallCC (14%), lung SqCC (8%), breast (8% of females), melanoma (3%), kidney (3%), colorectal (2%), and esophageal (1%). The distributions of brain tumor types differed significantly by age, sex, race/ethnicity, and insurance status.

CONCLUSIONS
In adult patients where the first manifestation of cancer includes an intracranial tumor, the most common diagnosis is either metastatic disease (predominantly from NSCLC) in males or benign meningiomas in females; but varies substantially by age group. Notably, our results adjust the traditional teaching that half of all new brain masses are BMs, which in fact represent only ~25% of new intracranial masses.
EPID-22. NEWLY-DIAGNOSED BRAIN TUMORS IN PEDIATRIC PATIENTS: EPIDEMIOLOGY IN THE UNITED STATES
Authors: Torre Matthew , Ascha Mustafa , Harary Maya , Smith Timothy , Aizer Ayal , Ligon Keith , Reardon David , Barnholtz-Sloan Jill , Iorgulescu Bryan 
Published: November 2019

Abstract

INTRODUCTION
Herein we examine the epidemiology across all pediatric intracranial tumors in the U.S.

METHODS
Pediatric patients (< 20yo) presenting between 2010–2015 with an intracranial tumor as the first evidence of cancer were queried from the National Cancer Database, which comprises >70% of cancers newly-diagnosed in the U.S. Tumor types were classified by WHO2016 ICD-O3.

RESULTS
14,952 pediatric patients without a history of cancer presented with intracranial tumors between 2010–2015. Across all ages, these were comprised of 1) 22% diffuse astrocytic and oligodendroglial (n=3,328), 2) 17% sellar region (n=2,530), 3) 16% other astrocytic (n=2,378, 2,131 were pilocytic and pilomyxoid), 4) 13% embryonal (n=1,896; 1,092 were classic histology medulloblastomas), 5) 7% neuronal and mixed neuronal-glial (n=981), 6) 5% ependymal (n=752), 7) 4% GCTs (n=615), 8) 3% mesenchymal non-meningothelial (n=492), 9) 3% nerve sheath (n=428), and 10) ≤2% each of meningioma, choroid plexus, brain metastatic (44% from neuroblastoma), pineal region, hematologic, and other glioma tumors. Embryonal tumors predominated in neonates and infants (0-2yo), diffuse gliomas in childhood (3-11yo), and sellar tumors in adolescents (12-19yo). Females represented 49% of the cases, but sellar tumors predominated (23%, vs. only 11% in males); whereas in males diffuse gliomas predominated (23%; vs. 22% in females) overall and in pediatric patients older than 2yo.

CONCLUSIONS
In U.S. pediatric patients that present with a new intracranial tumor, embryonal tumors and diffuse gliomas predominate in infants ≤2yo, and continue to predominate in male children 3-11yo, whereas female children 3-11yo shifted towards a predominance by diffuse gliomas and other astrocytic tumors (e.g. pilocytic and pilomyxoid). In female adolescents 12-19yo, sellar tumors predominated, followed by diffuse gliomas; whereas in male adolescents diffuse gliomas predominated, followed by other astrocytic tumors and sellar tumors. Our findings demonstrate that newly-diagnosed intracranial masses in pediatric patients significantly vary by both age and sex.
EPID-24. DOES THE LOCATION MATTER? CHARACTERIZATION OF THE ANATOMIC LOCATIONS, MOLECULAR PROFILES, AND CLINICAL FEATURES OF GLIOMAS
Authors: Mackintosh Christopher , Butterfield Richard , Zhang Nan , Bendok Bernard , Zimmerman Richard , Swanson Kristin , Porter Alyx , Mrugala Maciej 
Published: November 2019

Abstract

INTRODUCTION
Locations of gliomas may influence clinical presentations, molecular profiles, treatment options, and prognoses. Using the Mayo Clinic Arizona Cancer Center registry, we analyzed the frequency at which gliomas were identified in different regions of the brain. We evaluated molecular profiles, clinical courses and survival by anatomic location.

METHODS
Registry was queried to include patients with glioma over a 10-year period. Statistical analyses were used to compare demographic, genetic, and clinical characteristics among patients with gliomas in different locations.

RESULTS
182 gliomas were identified. Of the tumors confined to a single lobe, there were 51 frontal (28.0%), 50 temporal (27.5%), 22 parietal (12.1%), and 7 occipital tumors (3.8%) identified. Multifocal disease was noted in 38 patients (20.9%). Tumors affecting temporal lobe were associated with reduced overall survival when compared to all other tumors (11.0 months vs. 13.0 months, log-rank p=0.0068). However, this disparity became insignificant when adjusted for tumor grade, age, and surgical approach [HR(95% CI) 1.26(0.87, 1.82), p=0.212]. Out of 82 cases tested for IDH-1, 10 were mutated (5.5%). IDH-1 mutation was present in 6 frontal, 2 temporal, 1 thalamic, and 1 multifocal tumor. Out of 21 cases tested for 1p19q deletions, 12 were co-deleted, 9 of which were frontal lobe tumors. MGMT methylation was assessed in 45 cases; 7 of 14 frontal tumors and 6 of 13 temporal tumors were methylated. ATRX loss was detected in 2/42 assessed cases.

CONCLUSION
Our results support the hypothesis that the anatomical locations of gliomas influence patients’ clinical courses. Tumors involving the temporal lobe were associated with poorer survival, though this association appeared to be driven by these patients’ more aggressive tumor profiles and higher risk baseline demographics. Molecular analysis was limited by low prevalence of genetic testing in the study sample, highlighting the importance of capturing this information for all gliomas.
EPID-27. OCCURRENCE OF SYSTEMIC CANCER IN PATIENTS WITH ASTROCYTOMA: POPULATION CHARACTERIZATION AND COMPLICATIONS
Authors: Horta Erika , Snyder James , Walbert Tobias 
Published: November 2019

Abstract
It is unclear how the diagnosis of a second cancer influences the treatment and complications of patients with astrocytoma. A chart review of patients with astrocytoma and a second systemic cancer was performed to understand the possible complications that a systemic cancer diagnosis might bring to the treatment of the patient. Inclusion criteria was the histological diagnosis of diffuse or anaplastic astrocytoma and another non-skin systemic cancer. Exclusion criteria was the diagnosis of any genetic syndrome that predisposes tumorigenesis. A total of 17 patients were identified. The most common systemic cancer was thyroid (22) followed by colon and breast cancer (each one 17%). Men were 59% of the patients (p= 0.38), but older (60 +14 years, p=0.003) when compared to CBTRUS data. Systemic cancer was diagnosed before astrocytoma in 61% of the cases. Age at the diagnosis of systemic cancer was 48 +14 years. Only 9% of the patients who had systemic cancer before astrocytomas survived 5 years, what is less than expected when compared with literature, (p=0.02). Those also survived less than the patients that had systemic cancer after the diagnosis of astrocytomas (8.1+6.4 years). Thromboembolism was seen in 12.5% (p=0.8), always after the astrocytoma diagnosis. Thrombocytopenia was not related to prior chemotherapy. In patients with systemic cancer diagnosed while on treatment for astrocytoma, a delay or shortened course of the treatment was seen in rare cases, and one patient had their course of treatment for astrocytoma shortened. The conclusion of this chart review of patients with the diagnosis of astrocytoma and a systemic cancer identifies that this population is older than expected and the diagnosis of systemic cancer before astrocytoma might predict a shorter survival.
EPID-28. WHAT DO PATTERNS OF “UNCLASSIFIED” BRAIN TUMORS TELL US ABOUT INCIDENCE RATES OF NON-MALIGNANT BRAIN TUMORS IN CANADA?
Authors: Smith Trenton , Walker Emily , Yuan Yan , Davis Faith , Megyesi Joseph 
Published: November 2019

Abstract

BACKGROUND
Patients with non-malignant brain tumors (NMBT) can experience significant morbidity and mortality; the degree of which varies by histological subtype. A recent report on all primary brain tumors in Alberta (AB), British Columbia (BC), Manitoba (MB) and Ontario (ON) showed 19.1% of NMBT were categorized as ‘unclassified’. Missing data on histological subtypes encumbers efforts to understand the burden of disease associated with NMBT. The purpose of this analysis was to examine the distribution of unclassified tumors across participating provinces to identify targets for improved surveillance.

METHODS
Data were provided from cancer registries in AB, BC,MB, and ON. Age Standardized Incidence Rates (ASIR) and frequencies were estimated using SAS 9.4. Given data from the United States (U.S) is accurate and the population is comparable, ASIR of NMBT in the U.S were used as expected values in this analysis. The 2011 Canadian Population and the 2000 US population were used for standardization to compare within Canada and to U.S data respectively.

RESULTS
The ASIR of total NMBT and was highest in ON, relative to other participating provinces and similar to that of the U.S (15.25 and 15.91 cases/100,000 person-years, respectively). However, ON had an ASIR about 10 times higher than other provinces for unclassified tumors (ON:6.3 cases/100,000 person-years; BC: 0.4 cases/100,000 person-years; AB:0.3 cases/100,000 person-years; and MB:0.6 cases/100,000 person-years). When unclassified tumors were excluded from the analysis, the ASIR of NMBT was similar across participating provinces.

CONCLUSIONS
Findings from this analysis indicate that the Ontario provincial cancer registry has complete data on total NMBT cases. However, the high ASIR of unclassified cases in the NMBT category indicates that quality control measures could be improved. Further examination of the unclassified cases in ON could be used to improve the accuracy of the ON cancer registry and the completeness of other province’s registries.