An Examination of Determinants Affecting the Survival Duration Pediatric Brain Cancer Patients Through Stratified Cox Regression Analysis

Abstract

Brain cancer is the second most common pediatric malignancy and the leading cause of cancer-related mortality in children. Pediatric brain tumors (PBTs) represent around 25% of all pediatric cancers and consist of clinically and biologically diverse subtypes, with an estimated incidence of 0.3–2.9 cases per 100,000 children annually. The high prevalence emphasizes the importance of identifying factors that influence patient survival. This study aims to identify and analyze the factors that significantly affect the survival duration of pediatric brain cancer patients by applying the Stratified Cox regression model. This study utilized secondary data from the Pediatric Brain Cancer database (www.cbioportal.org). Independent variables included cancer type, ethnicity, other medical conditions, sex, tumor type, and treatment type, while the dependent variables were survival time (OS Months) and patient status (OS Status). Data were analyzed using the Stratified Cox regression method. A total of 203 patients were observed, consisting of 39 uncensored cases (19.21%) and 164 censored cases (80.79%). The majority of patients were male (58.62%), diagnosed with low-grade glioma/astrocytoma (43.35%), classified as non-Hispanic or Latino (93.52%), had no additional medical conditions (51.72%), received new treatment (85.22%), and were categorized with primary tumor type (74.38%). Results from the stratified Cox model indicated that cancer type was a significant predictor of survival. Children with embryonal tumors were found to have 8.9 times greater risk of experiencing an event compared to those with CNS cancer types, whereas children with high-grade glioma/astrocytoma had a 24.85 times higher risk compared to the CNS cancer group.