PURPOSE: To evaluate the impact of primary tumor site, age at diagnosis, extent of resection, and histology on progression-free survival (PFS) in pediatric low-grade astrocytoma. PATIENTS AND METHODS: Medical, pathologic, and imaging information were reviewed for 142 children (ages 2 months to 19 years) with low-grade astrocytoma treated between January 1984 and July 1994. Gross total resection (GTR) was attempted for cerebellar and cerebral hemisphere tumors, with biopsy or less aggressive resection used predominantly for tumors in other sites. Surgery was followed by observation in 107 cases, radiation therapy in 31, and chemotherapy in four. RESULTS: The overall survival rate was 90% +/- 3% (SE) at 4 years. PFS was significantly better for patients with cerebellar and cerebral hemisphere tumors (n = 75) than those with tumors in all other sites (P = .0006). Within the former group, there was no significant difference in PFS for patients in whom GTR was achieved versus those with incomplete resections (4-year estimates, 89% and 77%, respectively). Histology (juvenile pilocytic v astrocytoma not otherwise specified [NOS]) was not related to PFS in an analysis that controlled for tumor site and patient age. Patients younger than 5 years at diagnosis had a significantly poorer PFS than older children, regardless of histology (P < .03) or tumor site (P < .002). Treatment for progressive/recurrent disease was effective in a majority of patients, but appeared more successful in patients with hemispheric than thalamic or hypothalamic tumors. CONCLUSION: The overall survival in this series of pediatric low-grade astrocytomas is excellent. Age at diagnosis and tumor location, but not histology, had a significant impact on PFS. Efforts to improve treatment outcome should focus on young patients (< 5 years) and on those with central midline tumors. The majority of patients with completely resected hemispheric tumors were monitored without further therapy, which supports attempted GTR of cerebral and cerebellar hemisphere low-grade astrocytoma.
PURPOSE: To evaluate the impact of primary tumor site, age at diagnosis, extent of resection, and histology on progression-free survival (PFS) in pediatric low-grade astrocytoma. PATIENTS AND METHODS: Medical, pathologic, and imaging information were reviewed for 142 children (ages 2 months to 19 years) with low-grade astrocytoma treated between January 1984 and July 1994. Gross total resection (GTR) was attempted for cerebellar and cerebral hemisphere tumors, with biopsy or less aggressive resection used predominantly for tumors in other sites. Surgery was followed by observation in 107 cases, radiation therapy in 31, and chemotherapy in four. RESULTS: The overall survival rate was 90% +/- 3% (SE) at 4 years. PFS was significantly better for patients with cerebellar and cerebral hemisphere tumors (n = 75) than those with tumors in all other sites (P = .0006). Within the former group, there was no significant difference in PFS for patients in whom GTR was achieved versus those with incomplete resections (4-year estimates, 89% and 77%, respectively). Histology (juvenile pilocytic v astrocytoma not otherwise specified [NOS]) was not related to PFS in an analysis that controlled for tumor site and patient age. Patients younger than 5 years at diagnosis had a significantly poorer PFS than older children, regardless of histology (P < .03) or tumor site (P < .002). Treatment for progressive/recurrent disease was effective in a majority of patients, but appeared more successful in patients with hemispheric than thalamic or hypothalamic tumors. CONCLUSION: The overall survival in this series of pediatric low-grade astrocytomas is excellent. Age at diagnosis and tumor location, but not histology, had a significant impact on PFS. Efforts to improve treatment outcome should focus on young patients (< 5 years) and on those with central midline tumors. The majority of patients with completely resected hemispheric tumors were monitored without further therapy, which supports attempted GTR of cerebral and cerebellar hemisphere low-grade astrocytoma.
Authors: Joann L Ater; Tianni Zhou; Emiko Holmes; Claire M Mazewski; Timothy N Booth; David R Freyer; Ken H Lazarus; Roger J Packer; Michael Prados; Richard Sposto; Gilbert Vezina; Jeffrey H Wisoff; Ian F Pollack Journal: J Clin Oncol Date: 2012-06-04 Impact factor: 44.544
Authors: Andrea Maria Cappellano; Antonio Sergio Petrilli; Nasjla Saba da Silva; Frederico Adolfo Silva; Priscila Mendes Paiva; Sergio Cavalheiro; Eric Bouffet Journal: J Neurooncol Date: 2014-11-01 Impact factor: 4.130
Authors: Kristian Aquilina; David J Daniels; Helen Spoudeas; Kim Phipps; Hoong-Wei Gan; Frederick A Boop Journal: Childs Nerv Syst Date: 2015-08-16 Impact factor: 1.475
Authors: Guillaume Bergthold; Pratiti Bandopadhayay; Wenya Linda Bi; Lori Ramkissoon; Charles Stiles; Rosalind A Segal; Rameen Beroukhim; Keith L Ligon; Jacques Grill; Mark W Kieran Journal: Biochim Biophys Acta Date: 2014-02-28
Authors: Valerie N Barton; Andrew M Donson; Diane K Birks; Bette K Kleinschmidt-DeMasters; Michael H Handler; Nicholas K Foreman; Sarah Z Rush Journal: J Neuropathol Exp Neurol Date: 2013-05 Impact factor: 3.685
Authors: Matthias A Karajannis; Geneviève Legault; Michael J Fisher; Sarah S Milla; Kenneth J Cohen; Jeffrey H Wisoff; David H Harter; Judith D Goldberg; Tsivia Hochman; Amanda Merkelson; Michael C Bloom; Angela J Sievert; Adam C Resnick; Girish Dhall; David T W Jones; Andrey Korshunov; Stefan M Pfister; Charles G Eberhart; David Zagzag; Jeffrey C Allen Journal: Neuro Oncol Date: 2014-05-06 Impact factor: 12.300