Annette Leibetseder , Maximilian J. Mair , Anika Simonovska Serra , Zoltan Spiro , Martin Aichholzer , Georg Widhalm , Franziska Eckert , Adelheid Wöhrer , Raimund Helbok , Serge Weis , Matthias Preusser , Josef Pichler , Anna Sophie Berghoff
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The cohort was divided into 3 groups, defined as (A) nulliparae, (B) primi-/multiparae before glioma diagnosis, and (C) primi-/multiparae after glioma diagnosis. Survival analyses were performed in a time-dependent manner with parity as time-dependent covariate.</div></div><div><h3>Results</h3><div>159/368 females met our inclusion criteria, resulting in 47 (29.6 %) nulliparae, 88 (55.3 %) primi-/multiparae before glioma diagnosis and 24 (15.1 %) primi-/multiparae after glioma diagnosis. Median follow-up was 127.4 months (range 0.7–341.9), and median overall survival and progression free survival were 247.6 months (range 0.4–269.1) and 67.9 months (range 0.7–341.9), respectively. Overall, 113/159 (71.1 %) patients had tumour progression and 53/159 (33.3 %) deceased. In total, 57.4 % of the nullipara, 76.1 % of the primi-/multipara before glioma diagnosis and 79.1 % of the primi-/multipara after glioma diagnosis groups experienced tumour progression (p > 0.05). In multivariate time-dependent analysis, primi-/multiparae after glioma diagnosis presented with shorter progression free (HR 2.45, p = 0.0079), but not overall survival (HR 0.54, p > 0.05) in comparison to the other two groups.</div></div><div><h3>Conclusion</h3><div>Pregnancy after glioma diagnosis was associated with shorter progression free survival. Longer follow-up as well as larger cohorts are needed to investigate a potential impact on overall survival.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"218 ","pages":"Article 115259"},"PeriodicalIF":7.1000,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association of pregnancy with tumour progression in patients with glioma\",\"authors\":\"Annette Leibetseder , Maximilian J. Mair , Anika Simonovska Serra , Zoltan Spiro , Martin Aichholzer , Georg Widhalm , Franziska Eckert , Adelheid Wöhrer , Raimund Helbok , Serge Weis , Matthias Preusser , Josef Pichler , Anna Sophie Berghoff\",\"doi\":\"10.1016/j.ejca.2025.115259\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>A significant proportion of women in reproductive age are diagnosed with diffuse gliomas, resulting in the need to address the safety of pregnancy in patient consultation. However, data on glioma progression after and during pregnancy are sparse and controversial.</div></div><div><h3>Methods</h3><div>Female adult patients in their reproductive years (≥18 years and <46 years) with histological diagnosis of glioma between 01/01/2000 and 01/12/2019 from 2 academic centers have been included in the study. Re-classification according to the 2021 WHO classification of CNS tumours was performed. The cohort was divided into 3 groups, defined as (A) nulliparae, (B) primi-/multiparae before glioma diagnosis, and (C) primi-/multiparae after glioma diagnosis. Survival analyses were performed in a time-dependent manner with parity as time-dependent covariate.</div></div><div><h3>Results</h3><div>159/368 females met our inclusion criteria, resulting in 47 (29.6 %) nulliparae, 88 (55.3 %) primi-/multiparae before glioma diagnosis and 24 (15.1 %) primi-/multiparae after glioma diagnosis. Median follow-up was 127.4 months (range 0.7–341.9), and median overall survival and progression free survival were 247.6 months (range 0.4–269.1) and 67.9 months (range 0.7–341.9), respectively. Overall, 113/159 (71.1 %) patients had tumour progression and 53/159 (33.3 %) deceased. In total, 57.4 % of the nullipara, 76.1 % of the primi-/multipara before glioma diagnosis and 79.1 % of the primi-/multipara after glioma diagnosis groups experienced tumour progression (p > 0.05). 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引用次数: 0
摘要
相当大比例的育龄妇女被诊断为弥漫性胶质瘤，因此需要在患者咨询时解决妊娠安全性问题。然而，关于胶质瘤在怀孕后和怀孕期间进展的数据很少且有争议。方法纳入2000年1月1日至2019年12月1日来自2个学术中心的组织学诊断为胶质瘤的育龄期（≥18岁至46岁）女性成年患者。根据2021年WHO对中枢神经系统肿瘤的分类进行重新分类。将该队列分为3组，定义为(A)无神经胶质瘤组，(B)胶质瘤诊断前的原发性/多副组，(C)胶质瘤诊断后的原发性/多副组。生存分析以时间相关的方式进行，宇称为时间相关的协变量。结果368例女性中有159例符合我们的纳入标准，其中47例（29.6 %）为无瘤，88例（55.3 %）为胶质瘤诊断前原发性/多发性瘤，24例（15.1 %）为胶质瘤诊断后原发性/多发性瘤。中位随访时间为127.4个月（范围0.7-341.9），中位总生存期和无进展生存期分别为247.6个月（范围0.4-269.1）和67.9个月（范围0.7-341.9）。总体而言，113/159（71.1 %）患者肿瘤进展，53/159（33.3% %）患者死亡。总的来说，胶质瘤诊断前和胶质瘤诊断后分别有57.4% %、76.1 %和79.1% %的原发性/多发性旁位患者出现肿瘤进展（p >； 0.05）。在多变量时间依赖分析中，与其他两组相比，胶质瘤诊断后的原发性/多发病无进展时间较短（HR 2.45, p = 0.0079），但总生存时间较短（HR 0.54, p >； 0.05）。结论胶质瘤诊断后妊娠与较短的无进展生存期相关。需要更长的随访时间和更大的队列来调查对总体生存的潜在影响。
Association of pregnancy with tumour progression in patients with glioma
Background
A significant proportion of women in reproductive age are diagnosed with diffuse gliomas, resulting in the need to address the safety of pregnancy in patient consultation. However, data on glioma progression after and during pregnancy are sparse and controversial.
Methods
Female adult patients in their reproductive years (≥18 years and <46 years) with histological diagnosis of glioma between 01/01/2000 and 01/12/2019 from 2 academic centers have been included in the study. Re-classification according to the 2021 WHO classification of CNS tumours was performed. The cohort was divided into 3 groups, defined as (A) nulliparae, (B) primi-/multiparae before glioma diagnosis, and (C) primi-/multiparae after glioma diagnosis. Survival analyses were performed in a time-dependent manner with parity as time-dependent covariate.
Results
159/368 females met our inclusion criteria, resulting in 47 (29.6 %) nulliparae, 88 (55.3 %) primi-/multiparae before glioma diagnosis and 24 (15.1 %) primi-/multiparae after glioma diagnosis. Median follow-up was 127.4 months (range 0.7–341.9), and median overall survival and progression free survival were 247.6 months (range 0.4–269.1) and 67.9 months (range 0.7–341.9), respectively. Overall, 113/159 (71.1 %) patients had tumour progression and 53/159 (33.3 %) deceased. In total, 57.4 % of the nullipara, 76.1 % of the primi-/multipara before glioma diagnosis and 79.1 % of the primi-/multipara after glioma diagnosis groups experienced tumour progression (p > 0.05). In multivariate time-dependent analysis, primi-/multiparae after glioma diagnosis presented with shorter progression free (HR 2.45, p = 0.0079), but not overall survival (HR 0.54, p > 0.05) in comparison to the other two groups.
Conclusion
Pregnancy after glioma diagnosis was associated with shorter progression free survival. Longer follow-up as well as larger cohorts are needed to investigate a potential impact on overall survival.
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