Glioma in different life stages: A comparative analysis of adult and pediatric tumors

Gliomas are one of the most common primary brain tumors and their prognosis is highly dependent on patient-specific factors. The objective of our review is to detail how age influences the epidemiology, molecular pathogenesis, prognosis, and treatment of gliomas. A literature search was conducted for adult and pediatric gliomas (PG) at Google Scholar and PubMed, with relevant keywords like gliomas, World Health Organization (WHO) classification, histology, and treatment, etc., and papers published until 2023 were reviewed. It was found that males and non-Hispanic white people are particularly at risk in both age categories. People with poor socioeconomic status are more likely to have PG. While the overall incidence of adult gliomas has been declining, glioblastoma (GBM) occurrence has been rising. The latest WHO classification of central nervous system (CNS) tumors has highlighted the molecular aberrations to further stratify adult and PG, and literature review revealed how each type has unique histological features. The first line treatment for both groups is surgery followed by adjuvant radio- and chemotherapy, although radiotherapy use for children remains controversial. PGs can also be treated with targeted therapy of the Mitogen-activated protein kinase (MAPK) pathway and currently, anti-cancer drugs are being investigated. By juxtaposing pediatric and adult gliomas, several theories can be proposed about how certain gliomas develop at specific ages, how they vary in their presentations and management, and what can be further explored to improve patient outcomes. This information is pivotal for understanding not only how age influences the development of certain mutations but also how treatment varies according to a patient's age.