{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T07:26:52Z","timestamp":1773991612364,"version":"3.50.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T00:00:00Z","timestamp":1708992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Primary central nervous system (CNS) tumors are the second most common cancer in children and adolescents, leading to premature death and disability. Population-based survival estimates aid decision-making in cancer control, however data on survival for primary CNS tumors in Latin America is lacking. We describe survival rates for children with primary CNS tumors treated in ten Colombian cities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed data from children and adolescents newly diagnosed with cancer between 2012 and 2021, participating in the Childhood Cancer Clinical Outcomes Surveillance System (VIGICANCER) in ten cities in Colombia. VIGICANCER collects information on clinical outcomes from twenty-seven pediatric oncology units and conducts active follow-up every three months. VIGICANCER does not register craniopharyngiomas; we excluded intracranial germ cell tumors for this report. We used the Kaplan-Meier method to estimate the overall survival probability, stratified by sociodemographic variables, topography, WHO grading, receipt of radiation therapy, and type of surgical resection. We analyzed the prognostic capacity of variables using multivariate proportional Cox\u2019s regression, stratified by city and year of diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, VIGICANCER included 989 primary CNS tumors in 879 children and 110 adolescents. The cohort median age was 9 years; 53% of patients were males, and 8% were Afro-descendants. Most common tumors were supratentorial astrocytomas (47%), astrocytic tumors (35%), medulloblastomas (20%), ependymomas (11%), and mixed and unspecified gliomas (10%). Five-year overall survival of the entire cohort was 54% (95% CI, 51-58); for supratentorial gliomas, WHO grade I was 77%, II was 62%, III-IV was 27%, respectively, and for medulloblastoma was  61%. The adjusted hazard rate ratio for patients with WHO grade III and IV, for those with subtotal resection, for brainstem location, and for those not receiving radiation therapy was 7.4 (95% CI, 4.7\u201311.8), 6.4 (95% CI, 4.2\u20139.8), 2.8 (95% 2.1\u20133.8), 2.0 (95% CI, 1.3\u20132.8) and 2.3 (95% CI, 1.7\u20133.0), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found that half of Colombia\u2019s children and adolescents with primary CNS tumors survive five years, compared to 70% to 80% in high-income countries. In addition to tumor biology and location, gross total resection was crucial for improved survival in this cohort. Systematic monitoring of survival and its determinants provides empirical data for guiding cancer control policies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2023.1326788","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T04:30:29Z","timestamp":1709008229000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Primary central nervous system tumors survival in children in ten Colombian cities: a VIGICANCER report"],"prefix":"10.3389","volume":"13","author":[{"given":"Oscar","family":"Ramirez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivian","family":"Piedrahita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesus","family":"Ardila","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Pardo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edgar","family":"Cabrera-Bernal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Lopera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amaranto","family":"Suarez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos Andr\u00e9s","family":"Portilla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Narv\u00e1ez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela","family":"Rodriguez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ximena","family":"Castro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1ngel","family":"Castro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego Ivan","family":"Estupinan-Perico","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Valencia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda del Rosario","family":"\u00c1lvarez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier Enrique","family":"Fox","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Eduardo","family":"Bravo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Aristizabal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,2,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1200\/GO.20.00368","article-title":"Incidence, mortality, and survival trends of primary CNS tumors in Cali, Colombia, from 1962 to 2019","author":"Riano","year":"2020","journal-title":"JCO Glob Oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30186-9","article-title":"International incidence of childhood cancer, 2001\u201310: a population-based registry study","volume":"18","author":"Steliarova-Foucher","year":"2017","journal-title":"Lancet Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/23.3.458","article-title":"International incidence of childhood brain and spinal tumours","volume":"23","author":"Stiller","year":"1994","journal-title":"Int J Epidemiol Int Epidemiol Assoc"},{"key":"B4","volume-title":"International Incidence of Childhood Cancer, Volume III (electronic version)","author":"Steliarova-Foucher","year":"2017"},{"key":"B5","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.hoc.2021.08.012","article-title":"The epidemiology of central nervous system tumors","volume":"36","author":"Francis","year":"2022","journal-title":"Hematol\/Oncol Clinics North America WB Saunders"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20011215)92:12<3155::AID-CNCR10158>3.0.CO;2-C","article-title":"Population-based epidemiologic data on brain tumors in German children","volume":"92","author":"Kaatsch","year":"2001","journal-title":"Cancer"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.hoc.2021.08.001","article-title":"Central nervous system tumor classification: an update on the integration of tumor genetics","volume":"36","author":"McLendon","year":"2022","journal-title":"Hematol\/Oncol Clinics North America WB Saunders"},{"key":"B8","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1007\/s11060-008-9740-0","article-title":"Clinical epidemiology for childhood primary central nervous system tumors","volume":"92","author":"Bauchet","year":"2009","journal-title":"J Neurooncol"},{"key":"B9","first-page":"36","article-title":"The emerging field of neurosurgical oncology: novel techniques to optimize outcomes and minimize mishaps","volume":"54","author":"Black","year":"2007","journal-title":"Clin Neurosurg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.hoc.2021.08.002","article-title":"Imaging advances for central nervous system tumors","volume":"36","author":"Huang","year":"2022","journal-title":"Hematol\/Oncol Clinics North America WB Saunders"},{"key":"B11","doi-asserted-by":"publisher","first-page":"101733","DOI":"10.1016\/j.canep.2020.101733","article-title":"Childhood cancer: Survival, treatment modalities, late effects and improvements over time","volume":"71","author":"Erdmann","year":"2021","journal-title":"Cancer Epidemiol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)33326-3","article-title":"Global surveillance of trends in cancer survival 2000\u201314 (CONCORD-3): analysis of individual records for 37\u2008513\u2008025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries","volume":"391","author":"Allemani","year":"2018","journal-title":"Lancet"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1200\/JGO.19.00140","article-title":"Worldwide trends in survival from common childhood brain tumors: A systematic review","volume":"5","author":"Girardi","year":"2019","journal-title":"J Glob Oncol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.26633\/RPSP.2023.144","article-title":"Collaboration for success: the global initiative for childhood cancer in Latin America","volume":"47","author":"V\u00e1squez","year":"2023","journal-title":"Rev Panamericana Salud P\u00fablica"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(22)00637-4","article-title":"Long-term survival and cure fraction estimates for childhood cancer in Europe (EUROCARE-6): results from a population-based study","volume":"23","author":"Botta","year":"2022","journal-title":"Lancet Oncol"},{"key":"B16","volume-title":"Registro Oncopedi\u00e1trico Hospitalario Argentino Resultados 2000-2019. Septima","author":"Moreno","year":"2021"},{"key":"B17","unstructured":"Colombia Population2023"},{"key":"B18","unstructured":"Colombia countries data: Demographic and economy2023"},{"key":"B19","unstructured":"Colombia GINI coefficient2023"},{"key":"B20","unstructured":"World Bank. Colombia Poverty & Equity Brief2023"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1200\/JGO.17.00193","article-title":"Implementing a childhood cancer outcomes surveillance system within a population-based cancer registry","author":"Ramirez","year":"2018","journal-title":"J Glob Oncol"},{"key":"B22","first-page":"14","volume-title":"International classification of diseases for oncology","author":"Fritz","year":"2013"},{"key":"B23","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1007\/s00401-007-0243-4","article-title":"The 2007 WHO classifcation of tumours of the central nervous system","volume":"114","author":"Louis","year":"2007","journal-title":"Acta Neuropathol"},{"key":"B24","unstructured":"TorresFM\n            AcevedoOB\n          Universal Health Coverage Studies Series (UNICO) UNICO Studies Series No. 152013"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.28.3.853","article-title":"Colombia\u2019s universal health insurance system","volume":"28","author":"Giedion","year":"2009","journal-title":"Health Aff"},{"key":"B26","first-page":"49","article-title":"Closing the gap between formal and material health care coverage in Colombia","volume":"18","author":"Lamprea","year":"2016","journal-title":"Health Hum Rights"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70128-0","article-title":"Abandonment of treatment for childhood cancer: position statement of a SIOP PODC Working Group","volume":"12","author":"Mostert","year":"2011","journal-title":"Lancet Oncol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910400508","article-title":"A classification scheme for childhood cancer","volume":"40","author":"Birch","year":"1987","journal-title":"Int J Cancer"},{"key":"B29","volume-title":"An Introduction to Survival Analysis Using Stata","author":"Cleves","year":"2016"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noac161","article-title":"CBTRUS statistical report: pediatric brain tumor foundation childhood and adolescent primary brain and other central nervous system tumors diagnosed in the United States in 2014\u20132018","volume":"24","author":"Ostrom","year":"2022","journal-title":"Neuro Oncol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-018-2906-5","article-title":"The clinical importance of medulloblastoma extent of resection: a systematic review","volume":"139","author":"Thompson","year":"2018","journal-title":"J Neuro-Oncol Springer New York LLC"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00581-1","article-title":"Prognostic value of medulloblastoma extent of resection after accounting for molecular subgroup: a retrospective integrated clinical and molecular analysis","volume":"17","author":"Thompson","year":"2016","journal-title":"Lancet Oncol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.26551","article-title":"Extent of tumor resection and survival in pediatric patients with high-grade gliomas: A systematic review and meta-analysis","author":"Hatoum","year":"2022","journal-title":"JAMA Network Open Am Med Association"},{"key":"B34","year":"1981"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1200\/GO.20.00377","article-title":"Improving pediatric neuro-oncology survival disparities in the United States-Mexico border region: A cross-border initiative between San Diego, California, and Tijuana, Mexico","volume":"6","author":"Aristizabal","year":"2020","journal-title":"JCO Glob Oncol"},{"key":"B36","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/S1470-2045(13)70548-5","article-title":"Childhood cancer survival in Europe 1999-2007: Results of EUROCARE-5-a population-based study","volume":"15","author":"Gatta","year":"2014","journal-title":"Lancet Oncol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.phoj.2019.01.001","article-title":"Childhood cancer survival disparities in a universalized health system in Cali, Colombia","volume":"3","author":"Ramirez","year":"2018","journal-title":"Pediatr Hematol Oncol J"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30022-X","article-title":"The Lancet Oncology Commission Sustainable care for children with cancer: a Lancet Oncology Commission","volume":"21","author":"Jude","year":"2020","journal-title":"Lancet Oncol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2018-315962","article-title":"Accelerating diagnosis for childhood brain tumours: An analysis of the HeadSmart UK population data","volume":"105","author":"Shanmugavadivel","year":"2020","journal-title":"Arch Dis Child"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70010-X","article-title":"Sustaining innovation and improvement in the treatment of childhood cancer: Lessons from high-income countries","volume":"14","author":"Pritchard-Jones","year":"2013","journal-title":"Lancet Oncol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mds656","article-title":"The volume effect in paediatric oncology: A systematic review","volume":"24","author":"Knops","year":"2013","journal-title":"Ann Oncol Oxford Univ Press"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2019.04.024","article-title":"The European study on centralisation of childhood cancer treatment","volume":"115","author":"Gatta","year":"2019","journal-title":"Eur J Cancer"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2023.1326788\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T13:50:25Z","timestamp":1709646625000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2023.1326788\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,27]]},"references-count":42,"alternative-id":["10.3389\/fonc.2023.1326788"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2023.1326788","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,27]]},"article-number":"1326788"}}