Neuropathological and neuroradiological spectrum of pediatric malignant gliomas: correlation with outcome.

Autor:	Puget S; Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes, Paris, France. stephanie.puget@nck.aphp.fr, Boddaert N, Veillard AS, Garnett M, Miquel C, Andreiuolo F, Sainte-Rose C, Roujeau T, DiRocco F, Bourgeois M, Zerah M, Doz F, Grill J, Varlet P
Jazyk:	angličtina
Zdroj:	Neurosurgery [Neurosurgery] 2011 Jul; Vol. 69 (1), pp. 215-24.
DOI:	10.1227/NEU.0b013e3182134340
Abstrakt:	Background: The diagnostic accuracy and reproducibility for glioma histological diagnosis are suboptimal. Objective: To characterize radiological and histological features in pediatric malignant gliomas and to determine whether they had an impact on survival. Methods: We retrospectively reviewed a series of 96 pediatric malignant gliomas. All histological samples were blindly and independently reviewed and classified according to World Health Organization 2007 and Sainte-Anne classifications. Radiological features were reviewed independently. Statistical analyses were performed to investigate the relationship between clinical, radiological, and histological features and survival. Results: Cohort median age was 7.8 years; median follow-up was 4.8 years. Tumors involved cerebral hemispheres or basal ganglia in 82% of cases and brainstem in the remaining 18%. After histopathological review, low-grade gliomas and nonglial tumors were excluded (n = 27). The World Health Organization classification was not able to demonstrate differences between groups and patients survival. The Sainte-Anne classification identified a 3-year survival rate difference between the histological subgroups (oligodendroglioma A, oligodendroglioma B, malignant glioneuronal tumors, and glioblastomas; P = .02). The malignant glioneuronal tumor was the only glioma subtype with specific radiological features. Tumor location was significantly associated with 3-year survival rate (P = .005). Meningeal attachment was the only radiological criteria associated with longer survival (P = .02). Conclusion: The Sainte-Anne classification was better able to distinguish pediatric malignant gliomas in terms of survival compared with the World Health Organization classification. In this series, neither of these 2 histological classifications provided a prognostic stratification of the patients.
Databáze:	MEDLINE
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