A J Dodgshun1, J R Hansford2, M J Sullivan2. 1. Children's Haematology/Oncology Centre, Christchurch Hospital, Christchurch, New Zealand; Department of Paediatrics, University of Otago (Christchurch), Christchurch, New Zealand. Electronic address: andrew.dodgshun@cdhb.health.nz. 2. Children's Cancer Centre, Royal Children's Hospital, Melbourne, Victoria 3052, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria 3052, Australia; Murdoch Children's Research Institute, Melbourne, Victoria 3052, Australia.
Abstract
BACKGROUND: Paediatric glioma encompasses a wide range of entities with highly variable prognoses. Gliomas are grouped by histopathological features into high- and low-grade glioma but this classification until recently has not taken into account many emerging risk factors in this disease. A comprehensive risk classification has not been published for paediatric glioma despite many risk factors being established in this disease. METHODS: A comprehensive literature review was carried out identifying risk factors for paediatric low-grade and high-grade glioma. RESULTS: The most consistently described risk factors in high-grade glioma included midline location and extent of surgical resection. For patients with progressive unresectable low-grade glioma, age under 1, neurofibromatosis type I status and location were the most consistently prognostic. Molecular classification shows promise in accurately reassigning diagnosis for some gliomas. CONCLUSION: Risk profiling in paediatric glioma will require a focused multinational effort but will result in a more accurate and nuanced assessment of prognosis.
BACKGROUND: Paediatric glioma encompasses a wide range of entities with highly variable prognoses. Gliomas are grouped by histopathological features into high- and low-grade glioma but this classification until recently has not taken into account many emerging risk factors in this disease. A comprehensive risk classification has not been published for paediatric glioma despite many risk factors being established in this disease. METHODS: A comprehensive literature review was carried out identifying risk factors for paediatric low-grade and high-grade glioma. RESULTS: The most consistently described risk factors in high-grade glioma included midline location and extent of surgical resection. For patients with progressive unresectable low-grade glioma, age under 1, neurofibromatosis type I status and location were the most consistently prognostic. Molecular classification shows promise in accurately reassigning diagnosis for some gliomas. CONCLUSION: Risk profiling in paediatric glioma will require a focused multinational effort but will result in a more accurate and nuanced assessment of prognosis.