Malignant gliomas of the cerebellum: an analytic review.

Using an analytical review, the demographic data on malignant cerebellar gliomas such as length of survival, and those factors associated with prolonged survival were examined. Seventy-one cases of malignant cerebellar glioma reported since 1975 were combined and reviewed with the seven cases treated at our institution since that time. Thirty-seven patients (47%) had grade III tumors and 41 (53%) had grade IV tumors. Fifty-nine percent of the tumors were located in the hemispheres and 41% were found in the vermis. Median survival for patients with grade III anaplastic astrocytomas was 32 months compared to 11 months for those with grade IV glioblastomas multiforme (P = 0.0257). For the entire cohort, patients with grade III tumors, those who had a surgical resection, and those that had received radiation therapy for treatment of their tumor had prolonged survival on multivariable analysis. Radiation therapy was associated with extended survival for patients with grade III tumors by uni- and multivariate analysis. For grade IV tumors, univariate analysis revealed prolonged survival for those patients who had surgical resection compared to those who had biopsy alone (P = 0.0036) and for those who received external beam radiation therapy (P = 0.0001). Patients with malignant gliomas of the cerebellum had length of survival comparable to their supratentorial counterparts. Prompt diagnosis and treatment may explain the similarity in survival found between supra- and infratentorial malignant gliomas despite an expected shorter survival because of treatment limitations. Surgical resection followed by radiation therapy is recommended for patients with malignant gliomas of the cerebellum.