A Population-Based Study of Pediatric and Adult Brainstem Glioma: Prognostic Nomograms for Overall and Cancer-Specific Survival.

AIM: To establish an effective predictive model to inform clinical practice for brainstem glioma, a rare and highly aggressive tumor of the central nervous system, given the lack of prior retrospective studies using the SEER database that have included both pediatric and adult patients. MATERIAL and METHODS: Cases of brainstem tumors diagnosed between 2000 and 2022 were identified from the SEER database. X-tile software and Maxstat were used to define the optimal tumor size cutoff value and risk subgroups for brainstem glioma. Independent prognostic factors were determined using univariate and multivariate Cox proportional hazards regression. These factors were used to construct two nomograms predicting 1-, 2-, and 3-year overall survival and cancer-specific survival for brainstem glioma. RESULTS: Age, tumor size, histological type, surgery, radiation, and chemotherapy were identified as independent prognostic factors for overall and cancer-specific survival. Notably, gross total resection was significantly associated with improved survival outcomes. CONCLUSION: This work enhances our understanding of the prognosis of brainstem glioma and corroborates the importance of surgical resection as a prognostic factor in its management. The validated nomograms offer a superior and personalized tool for risk stratification and prognostic estimation, which may be helpful for clinical decision making and patient counseling.