PURPOSE: Pediatric brain stem tumors (BsT) are a heterogeneous group of diseases. Our aim was to analyze our experience to find out prognostic factors. METHOD: A retrospective study with BsT patients was performed. Imaging characteristics, extension of surgery, pathology, and adjuvant therapy were analyzed and correlated with overall survival (OS) and progression-free survival (PFS) as outcome measures. RESULT: Since 1980 to 2010, we analyzed 65 BsT patients, 41 of them girls (63%), median age of 8 years (range 13.9 months to 17.6 years). Twenty-two patients (33.8%) had diffuse intrinsic pontine gliomas (DIPG) and 43 (66.2%) presented with focal BsT. Histology was available in 42 patients; the most frequent is low-grade glioma in 24/42 patients (57%). DIPG's histology (obtained usually at necropsy) confirmed five high-grade gliomas. After median follow-up of 49.3 months (0.5-175 months), 20/22 DIPG patients have died (90.9%), while 27/43 with focal tumors were alive (62.8%). Variables related to outcome were histology (better for low-grade glioma (LGG) OS p < 0.001), surgery (better if operated OS p < 0.001), and adjuvant therapy (worse if given, PFS p = 0.001, OS p = 0.024). The outcome for DIPG was dismal, median OS/EFS of 14.2/9.4 months, significantly worse than focal BsT (p = 0.000), while OS/EFS was 122.8/87.2 months for focal intrinsic, 88.2/47.1 months for exophytic, and 124.4/54 months for cervico-medullary tumors: no differences were found among them, except the histology (OS p < 0.001 for low-grade vs high-grade tumors). CONCLUSION: BsT in children comprised two different groups: diffuse (DIPG) and focal gliomas. The DIPGs continue having a dismal prognosis, needing new approaches, while focal tumors including LGG have better prognosis.
PURPOSE: Pediatric brain stem tumors (BsT) are a heterogeneous group of diseases. Our aim was to analyze our experience to find out prognostic factors. METHOD: A retrospective study with BsT patients was performed. Imaging characteristics, extension of surgery, pathology, and adjuvant therapy were analyzed and correlated with overall survival (OS) and progression-free survival (PFS) as outcome measures. RESULT: Since 1980 to 2010, we analyzed 65 BsT patients, 41 of them girls (63%), median age of 8 years (range 13.9 months to 17.6 years). Twenty-two patients (33.8%) had diffuse intrinsic pontine gliomas (DIPG) and 43 (66.2%) presented with focal BsT. Histology was available in 42 patients; the most frequent is low-grade glioma in 24/42 patients (57%). DIPG's histology (obtained usually at necropsy) confirmed five high-grade gliomas. After median follow-up of 49.3 months (0.5-175 months), 20/22 DIPGpatients have died (90.9%), while 27/43 with focal tumors were alive (62.8%). Variables related to outcome were histology (better for low-grade glioma (LGG) OS p < 0.001), surgery (better if operated OS p < 0.001), and adjuvant therapy (worse if given, PFS p = 0.001, OS p = 0.024). The outcome for DIPG was dismal, median OS/EFS of 14.2/9.4 months, significantly worse than focal BsT (p = 0.000), while OS/EFS was 122.8/87.2 months for focal intrinsic, 88.2/47.1 months for exophytic, and 124.4/54 months for cervico-medullary tumors: no differences were found among them, except the histology (OS p < 0.001 for low-grade vs high-grade tumors). CONCLUSION: BsT in children comprised two different groups: diffuse (DIPG) and focal gliomas. The DIPGs continue having a dismal prognosis, needing new approaches, while focal tumors including LGG have better prognosis.
Authors: D C Bowers; C Georgiades; L J Aronson; B S Carson; J D Weingart; M D Wharam; E R Melhem; P C Burger; K J Cohen Journal: Pediatr Neurosurg Date: 2000-01 Impact factor: 1.162
Authors: Tabitha Cooney; Adam Lane; Ute Bartels; Eric Bouffet; Stewart Goldman; Sarah E S Leary; Nicholas K Foreman; Roger J Packer; Alberto Broniscer; Jane E Minturn; Chie-Schin Shih; Murali Chintagumpala; Tim Hassall; Nicholas G Gottardo; Hetal Dholaria; Lindsey Hoffman; Brooklyn Chaney; Joshua Baugh; Renee Doughman; James L Leach; Blaise V Jones; Maryam Fouladi; Katherine E Warren; Michelle Monje Journal: Neuro Oncol Date: 2017-09-01 Impact factor: 12.300
Authors: Trent R Hummel; Ralph Salloum; Rachid Drissi; Shiva Kumar; Matthew Sobo; Stewart Goldman; Ahna Pai; James Leach; Adam Lane; David Pruitt; Mary Sutton; Lionel M Chow; Laurie Grimme; Renee Doughman; Lori Backus; Lili Miles; Charles Stevenson; Maryam Fouladi; Mariko DeWire Journal: J Neurooncol Date: 2015-12-01 Impact factor: 4.130
Authors: Mohamed Reda Rady; Abd Elrhman Enayet; Amal Refaat; Hala Taha; Waleed Said; Eslam Maher; Mohamed A El Beltagy Journal: Childs Nerv Syst Date: 2021-11-17 Impact factor: 1.475
Authors: Stefano Gabriele Vallero; Daniele Bertin; Maria Eleonora Basso; Laura Stefania Pittana; Anna Mussano; Franca Fagioli Journal: Childs Nerv Syst Date: 2014-01-14 Impact factor: 1.475
Authors: Carlo Cosimo Quattrocchi; Yuri Errante; Maria Camilla Rossi Espagnet; Stefania Galassi; Sabino Walter Della Sala; Bruno Bernardi; Giuseppe Fariello; Daniela Longo Journal: World J Radiol Date: 2016-01-28