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Trends in the Incidence and Survival of Adult-Onset Medulloblastoma

Background: Medulloblastoma (MB) is a central nervous system malignancy that rarely affects adult. Epidemiological trends of adult MB are limited. This study aimed to explore population-level trends in the incidence of adult MB and to examine potential predictors for overall survival (OS). 
 
Methods: Data for patients from 1973 to 2015 were extracted from the Surveillance, Epidemiology and End Results (SEER) database. Age-adjusted incidence rates (AAIR) were calculated for groups divided on the basis of age, gender, and ethnicity. Propensity-score matching was used to compensate for potential selection biases. Cox proportional hazard models were used to examine potential predictors for OS. 
 
Results: AAIR was stable among MB patients ≥20 yr of age. The AAIR was slightly higher in males than that in females (0.065 vs. 0.049 per 100,000). Compared to whites, the incidence was nearly doubled in individuals of black ethnicity (0.063 vs. 0.033 per 100,000). Incidence was also lower among patients ≥40 yr of age, compared to those 20-39 yr of age (0.025 vs. 0.107 per 100,000). Multivariate Cox analysis indicated that age (p <0.001) and surgical resection (p =0.002) were independent prognostic factors for OS in adult MB. PSM revealed that age (p<0.001), surgical resection (p=0.012), histology (p=0.031), insurance status (p=0.014), and marital status (p=0.040) had significant effects on OS. 
 
Conclusions: This study demonstrated that adult MB patients could benefit from GTR and young age. In addition, race-, gender- and age-disparities were linked with the trends in MB incidence and survival. 
 
Funding: This study was supported by Joint Funds for the Innovation of Science and Technology, Fujian Province (No. 2017Y9074) and the Key Clinical Specialty Discipline Construction Program of Fujian, People’s Republic of China. 
 
Conflict of Interest: The authors report no potential conflicts of interest. 
 
Ethical Approval: The data analysed and used in this study was obtained from Surveillance, Epidemiology, and End Results (SEER) database in accordance with the SEER data use agreement. Therefore, this study did not require approval of ethical board.