Browsing by Author "Diaz-Coronado, RY"

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An international study evaluating the epidemiology of intracranial germ cell tumors in the native versus immigrant Japanese populations: the need for an international registry
(Springer, 2022) Plant-Fox, AS; Suzuki, T; Diaz-Coronado, RY; Epelman, S; Sakamoto, L; Cheng, S; Yanagisawa, T; Rosner, B; Chi, SN; Kieran, MW
Background: Pediatric intra-cranial germ cell tumors (iGCTs) occur at an incidence of 0.6–1.2 cases/million/year in Western countries. The incidence is reported up to 5 times higher in Japan. It is unknown whether this increased incidence is due to genetic predisposition or environment. Methods: The incidence of iGCTs in children ages 0–19 years was evaluated from December 1st, 1996-December 1st, 2016 in stable Japanese immigrant populations living abroad and compared to current native Japanese registry data. The incidence of medullobblastoma was used as a control to account for assumptions in the data. Sites were identified based on historical and population data of known large scale emigration from Japan during a period of industrialization from 1868–1912 which resulted in large, stable Japanese immigrant populations abroad. These three representative sites included Lima, Peru, San Paolo, Brazil, and Vancouver, Canada. Data was collected from registry and hospital-based resources within each region. Results: A review of the Brain Tumor Registry of Japan from 1984–2004 revealed an incidence of 2.5 cases/million/year, lower than previously reported, and a lower incidence of medulloblastoma at 1.2 cases/million/year. Data from Vancouver, Canada, Lima, Peru, and San Paolo, Brazil included a total population of 731,174 Japanese persons. The ratio of all medulloblastoma to iGCT cases in Japan was identified as 1:2 while the ratio was 2:1, 6.5:1, and 5:1, respectively, in the other three locations. The data suggests increased incidence in native Japan may not translate to higher incidence in immigrant Japanese populations abroad and a clear genetic component was not found in our data set. Conclusions: A more precise and comprehensive study is needed to determine the cause of this difference in incidence. This study also emphasizes the importance of national and state registries and is a call to collaborate on state and country level epidemiology studies.
Factors influencing outcomes of older children with medulloblastoma over 15 years in Peru, a resource-limited setting
(John Wiley and Sons Inc, 2022) Diaz-Coronado, RY; Reinecke, JB; Stanek, JR; Finlay, JL; Hernández-Broncano, E; Chávez-Paredes, S; Miranda-Tunque, Y; Heredia Zelaya, A; Casavilca-Zambrano, S; García-Corrochano Medina, P; Ojeda Medina, L; Orrego Puelles, E; Torres Malca, E; Sernaque-Quintana, R; Quispe-Valverde, W; García León, JL; Osorio, DS
Background: Medulloblastoma is the most common malignant brain tumor in children. While survival has improved in high-income countries (HIC), the outcomes for patients in low-to-middle-income countries (LMIC) are unclear. Therefore, we sought to determine the survival of children with medulloblastoma at the Instituto Nacional de Enfermedades Neoplasicas (INEN) between 1997 and 2013 in Peru. Methods: Between 1997 and 2013, data from 103 children older than 3 years with medulloblastoma were analyzed. Fourteen patients were excluded. The patients were split into two distinct cohorts, 1997–2008 and 2009–2013, corresponding with chemotherapy regimen changes. Event-free (EFS) and overall survival (OS) were calculated using the Kaplan–Meier method, whereas prognostic factors were determined by univariate analysis (log-rank test). Results: Eighty-nine patients were included
Survival and prognostic factors in pediatric patients with medulloblastoma treated at a national pediatric hospital in Peru: a retrospective cohort
(American Association of Neurological Surgeons, 2023) Flores-Sanchez, JD; Perez-Chadid, DA; Diaz-Coronado, RY; Hernandez-Broncano, E; Ugas-Charcape, CF; Ramirez, A; Racchumi-Vela, AE; Boop, FA; Preguntegui, I
OBJECTIVE The objectives of this study were to determine the overall survival (OS) and event-free survival (EFS) rates of patients with medulloblastoma treated in a national pediatric hospital in Peru, as well as to identify demographic, clinical, imaging, postoperative, and histopathological characteristics and prognostic factors associated with OS and EFS. METHODS The authors conducted a retrospective study analyzing information from the medical records of children with a diagnosis of medulloblastoma who underwent surgical treatment at the Instituto Nacional de Salud del Niño—San Borja, a public hospital in Lima, Peru, from 2015 to 2020. Clinical-epidemiological variables, degree of disease extension, risk stratification, extent of resection, postoperative complications, status of oncological treatment received, histological subtype, and neurological sequelae were taken into account. The Kaplan-Meier method and Cox regression analysis were used to estimate OS, EFS, and prognostic factors. RESULTS Of the 57 children evaluated with complete medical records, only 22 children (38.6%) underwent complete oncological treatment. OS was 37% (95% CI 0.25–0.55) at 48 months. EFS was 44% (95% CI 0.31–0.61) at 23 months. High-risk stratification—meaning patients with ≥ 1.5 cm2 of residual postoperative tumor, those younger than 3 years, those with disseminated disease (HR 9.69, 95% CI 1.40–67.0, p = 0.02), and those who underwent subtotal resection (HR 3.78, 95% CI 1.09–13.2, p = 0.04)—was negatively associated with OS. Failure to receive complete oncological treatment was negatively associated with OS (HR 20.0, 95% CI 4.84–82.6, p < 0.001) and EFS (HR 7.82, 95% CI 2.47–24.7, p < 0.001). CONCLUSIONS OS and EFS of patients with medulloblastoma in the author’s milieu are below those reported in developed countries. Incomplete treatment and treatment abandonment in the authors’ cohort were also high compared with high-income country statistics. Failure to complete oncological treatment was the most important factor associated with poor prognosis, both in terms of OS and EFS. High-risk patients and subtotal resection were negatively associated with OS. Interventions are needed to promote the completion of adjuvant oncological therapy for medulloblastoma in the disadvantaged Peruvian population.
The role of maternal age & birth order on the development of unilateral and bilateral retinoblastoma: a multicentre study
(Springer Nature, 2023) Lloyd, P; Westcott, M; Kaliki, S; Ji, X; Zou, Y; Rashid, R; Sultana, S; Sherief, ST; Cassoux, N; Diaz-Coronado, RY; Garcia-Leon, JL; Lopez, AMZ; Polyakov, VG; Ushakova, TL; Roy, SR; Ahmad, A; Harby, LA; Berry, JL; Kim, J; Polski, A; Astbury, NJ; Bascaran, C; Blum, S; Bowman, R; Burton, MJ; Foster, A; Gomel, N; Keren-Froim, N; Madgar, S; Stacey, AW; Mohamed, A; Zondervan, M; Sagoo, MS; Fabian, ID; Reddy, MA
Background/Objectives: Retinoblastoma is a common childhood intraocular malignancy, the bilateral form of which most commonly results from a de novo germline pathogenic variant in the RB1 gene. Both advanced maternal age and decreasing birth order are known to increase the risk of de novo germline pathogenic variants, while the influence of national wealth is understudied. This cohort study aimed to retrospectively observe whether these factors influence the ratio of bilateral retinoblastoma cases compared to unilateral retinoblastoma, thereby inferring an influence on the development of de novo germline pathogenic variants in RB1. Subjects/Methods: Data from 688 patients from 11 centres in 10 countries were analysed using a series of statistical methods. Results: No associations were found between advanced maternal age, birth order or GDP per capita and the ratio of bilateral to unilateral retinoblastoma cases (p values = 0.534, 0.201, 0.067, respectively), indicating that these factors do not contribute to the development of a de novo pathogenic variant. Conclusions: Despite a lack of a definitive control group and genetic testing, this study demonstrates that advanced maternal age, birth order or GDP per capita do not influence the risk of developing a bilateral retinoblastoma.