Pilocytic astrocytomas in children: prognostic factors--a retrospective study of 80 cases
| Autor: | Armando Paz Paredes, Corinne Bouvier-Labit, Carla Fernandez, Gabriel Lena, Joanny Gouvernet, Nadine Girard, Dominique Figarella-Branger |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Male
medicine.medical_specialty Pathology Adolescent Brain tumor Astrocytoma Central nervous system disease Glioma Outcome Assessment Health Care medicine Humans Spinal Cord Neoplasms Child Survival rate Retrospective Studies Pilocytic astrocytoma business.industry Brain Neoplasms Optic Nerve Neoplasms Age Factors Infant Anatomical pathology Retrospective cohort study medicine.disease Prognosis Magnetic Resonance Imaging Survival Rate Child Preschool Surgery Female Neurology (clinical) Radiology business Tomography X-Ray Computed Follow-Up Studies |
| Zdroj: | Neurosurgery. 53(3) |
| ISSN: | 0148-396X |
| Popis: | OBJECTIVE Pilocytic astrocytomas (PA) are Grade I brain tumors characterized by an excellent prognosis. In some cases, however, the patient has a bad outcome. The aim of our study was to search for the clinicopathological factors underlying the prognosis for patients with this disease. METHODS We reviewed the clinical, neuroradiological, and histopathological features of 80 PAs (33 cerebellar, 18 optochiasmatic, 16 brainstem, 7 spinal cord, 3 thalamic, 2 optic nerve, and 1 hemispheric) in pediatric patients. RESULTS Pathological examination revealed 58 classic PAs and 20 pilomyxoid astrocytomas, which are a histological variant of PAs. Two cases remained unclassified. The mean overall follow-up period was 58 months, the 5-year progression-free survival rate was 75%, and the 5-year survival rates were 100 and 92% after total and partial removal. Univariate statistical analysis revealed that partial resection, optochiasmatic PA localization, and pilomyxoid variant were associated with a worse prognosis, but the latter two parameters were too closely related to the extent of resection to be independent prognostic factors in multivariate analysis. Among the patients who underwent partial surgical removal, only invasion of the surrounding structures was related to prognosis. CONCLUSION PAs are benign tumors, but some clinicopathological factors, such as partial resection, optochiasmatic location, invasion of surrounding structures, and the pilomyxoid variant, have a worse prognosis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|