Comparison of survival between the UK and US after surgery for most common pediatric CNS tumors.

Central nervous system tumors are the most common solid tumors in children. In an era of increasing accountability, it is surprising that there is so little published literature comparing outcomes after surgery for CNS tumor.1 Regulatory bodies, peers, and patients alike expect objective evidence of performance2,3 so that they can make informed decisions—yet the CNS tumor literature is largely limited to individual or institutional case series or trials comparing different treatment strategies. We recently reviewed early postoperative mortality for children with CNS tumors in the UK.4 The 30-day mortality of 2.7% was higher than that seen in most modern series (∼1%)—and some rare tumors in the UK series had 30-day mortality rates of 9%–13%. To further examine the outcome of children receiving surgical treatment for CNS tumors in the UK, we report here a population-based study looking at 1-, 5-, and 10-year survival for the most common histologically confirmed pediatric CNS tumor types. In addition, we compared these results from the UK with those published in the literature and those recorded in the USA by the Surveillance, Epidemiology, and End Results (SEER) data set. The SEER program is run by the National Cancer Institute and has evolved over time to collect data covering 28% of the US population.5 Treatment modalities are not recorded in the UK registry, and we have therefore not tried to analyze for other treatments (chemotherapy or radiotherapy). In effect, our study looks at the overall outcome of patients with a tissue diagnosis managed in the US (SEER) and compares this with the outcome of children managed in the UK.