Low-grade gliomas of the cerebral hemispheres in children : an analysis of 71 cases

摘要: Low-grade gliomas constitute the largest group of cerebral hemispheric tumors in pediatric population. Although complete tumor resection is generally goal management these lesions, this can prove difficult to achieve because margins may blend into surrounding brain. This raises several important questions on long-term behavior residual and role adjuvant therapy lesions. To examine issues, authors reviewed their experience 71 children with low-grade who were treated at institution between 1956 1991 assessed relationship clinical, radiographic, pathological, treatment-related factors outcome. Only seven patients series died, one from perioperative complications, five progressive disease, (a child neurofibromatosis) a second neoplasm. For 70 survived period, overall actuarial survivals 5, 10, 20 years 95%, 93%, 85%, respectively; progression-free status was maintained 88%, 79%, 76%, respectively. On univariate analysis, factor that most strongly associated both survival extent (p = 0.013 p 0.015, respectively). A present pilocytic astrocytomas 0.041) those nonpilocytic 0.037). Histopathological diagnosis also analysis; poorer results seen astrocytoma compared other gliomas, such as astrocytoma, mixed glioma, oligodendroglioma 0.021). The use radiotherapy not significant improvement 0.6). All three ultimately developed histologically confirmed anaplastic changes vicinity original had received prior radiotherapy, 20, 46, 137 months, respectively, before detection malignant progression. In addition, significantly higher incidence late cognitive endocrine dysfunction than nonirradiated < 0.01 0.05, conclude hemispheres have an excellent prognosis. Complete provides best opportunity for survival. However, even incomplete excision, common.(ABSTRACT TRUNCATED AT 400 WORDS)