# Epidemiology and Outcome of Primary Central Nervous System Tumors Treated at King Hussein Cancer Center

## TL;DR

This study examines the types and survival rates of brain and spinal tumors in Jordan, finding that adult and male patients have worse outcomes, and certain genetic mutations improve survival.

## Contribution

The study provides the first detailed epidemiological and survival analysis of primary CNS tumors in Jordan, highlighting regional trends and genetic influences.

## Key findings

- Gliomas are the most common CNS tumors in Jordan, with adult-type diffuse gliomas showing the lowest survival rates.
- Male patients and adults have significantly worse survival outcomes compared to females and children.
- IDH-mutant adult gliomas show better survival rates than IDH-wildtype gliomas.

## Abstract

This study investigates the epidemiology and outcome of primary central nervous system (CNS) tumors treated at the King Hussein Cancer Center (KHCC) in Jordan. We analyzed data from over 2000 patients diagnosed between 2003 and 2019. Our findings show that gliomas are the most common type of CNS tumor, and survival rates differ significantly between age groups and genders. Adult patients had lower survival rates compared to pediatric patients, and male patients had poorer outcomes compared to females. We also observed that tumors with specific genetic mutations had better survival rates. These findings align with global trends but highlight the growing burden of CNS tumors in the region. This research is crucial for understanding the unique aspects of CNS tumors in Jordan and emphasizes the need for region-specific cancer policies and improved diagnostic tools.

Background and Objectives: Primary central nervous system (CNS) tumors are often associated with relatively poor outcomes. Data on the epidemiology and outcome of CNS tumors in Jordan are scarce. We aim to report the epidemiology and outcome of primary CNS tumors of patients managed at a comprehensive cancer care center in Jordan. Methods: We performed a retrospective chart review of all Jordanian patients with a primary CNS tumor diagnosis who were managed at the center between July 2003 and June 2019. We included all entities described in the 2021 CNS WHO classification system, in addition to pituitary neuroendocrine tumors (PitNETs). We used the Kaplan–Meier method to estimate the 1-year, 2-year, and 5-year overall survival (OS) rates for each entity. Results and Findings: We included 2094 cases. The numbers of pediatrics and adults were 652 (31.1%) and 1442 (68.9%), respectively. The three most common groups of tumors were “gliomas, glioneuronal tumors, and neuronal tumors” (n = 1200 [57.30%]), followed by meningiomas (n = 261 [12.5%]), embryonal tumors (n = 234 [11.2%]). The three most common tumor families were adult-type diffuse gliomas (n = 709 [33.8%]), medulloblastoma (n = 199 [9.5%]), and circumscribed astrocytic gliomas (n = 183 [8.7%]). The median survival for the entire cohort was 97 months (95CI; 81–112). Survival was significantly worse for males and adults compared to their respective counterparts. Among the most common tumor group, “gliomas, glioneuronal tumors, and neuronal tumors”, OS rates for adult-type diffuse gliomas were significantly lower than all other types. Overall, adult gliomas with IDH-mutations had a survival advantage over wildtype cases (IDH-mutant 1-year OS, 89% [82–97%] vs. IDH-wildtype 1-year OS, 60% [52–70%]; p < 0.001). Conclusions: We present a detailed analysis of the primary CNS tumors diagnosed in the largest cancer center in Jordan between 2003 and 2019. We compared the epidemiology and overall survival of these patients to worldwide estimates and found the epidemiology and outcome of these tumors comparable to worldwide trends.