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Published on: March 7, 2017
Oligodendrogliomas in children
Kimberly M Creach1, Joshua B Rubin, Jeffery R Leonard
1Department of Radiation Oncology and Mallinckrodt Institute of Radiology, Washington University School of Medicine, 660 South Euclid Avenue, Saint Louis, MO 63110, USA.
Insights
Pediatric oligodendrogliomas have excellent survival, but one-third progress. Gross total resection and age over 3 years at diagnosis improve progression-free survival in children with these rare CNS tumors.
Area of Science:
- Pediatric Oncology
- Neuro-Oncology
- Central Nervous System Tumors
Background:
- Oligodendrogliomas are rare central nervous system (CNS) tumors in children.
- Identifying prognostic factors is crucial for optimizing treatment strategies.
Purpose of the Study:
- To identify prognostic factors for progression-free survival (PFS) and overall survival (OS) in pediatric oligodendroglioma patients.
Main Methods:
- Retrospective analysis of clinical data from 37 pediatric patients.
- Kaplan-Meier method for survival rates and log-rank test for curve differences.
Main Results:
- 5-year PFS was 66.4% and OS was 93.4%.
- Gross total resection (GTR) and age >3 years at diagnosis significantly improved PFS.
- Mixed histology was linked to worse OS; neither chemotherapy nor radiation improved outcomes.
Conclusions:
- Pediatric oligodendrogliomas have excellent OS, but disease progression is common.
- Patients with subtotal resection/biopsy and age <3 years are at higher risk for progression.
- GTR and older age at diagnosis are key predictors of improved PFS.
Abstract:
Oligodendrogliomas are rare central nervous system (CNS) tumors in children. The purpose of this study was to identify prognostic factors for progression free survival (PFS) and overall survival (OS) in pediatric patients with oligodendrogliomas. We retrospectively analyzed clinical data on 37 pediatric patients with oligodendroglial tumors treated at Washington University. Kaplan-Meier method was used to calculate survival rates. Log-rank was used to detect the difference between survival curves. The median age was 11.1 years (range 10 months-18 years), and median follow-up was 4.5 years (range 2 months-30.5 years). The 5-year PFS and OS were 66.4 and 93.4%, respectively. Mixed histology was associated with worse OS compared to patients with pure oligodendroglioma, 5-year OS 77.6 versus 100% (P < 0.01). Patients who underwent gross total resection (GTR) experienced an improved 5-year PFS of 100% compared to 28.8% (P = 0.03) in patients treated with subtotal resection (STR) or biopsy alone. Age >3 years at diagnosis correlated with improved 5-year PFS, 33.3 versus 69.8% (P = 0.01). Neither post-operative chemotherapy nor radiation therapy correlated with improved outcome. GTR and age >3 years at diagnosis remained significant for improved PFS on multivariate analysis. There were no factors correlated with improved overall survival on multivariate analysis. Pediatric oligodendroglial tumors are associated with excellent OS; however, a third of patients developed progressive disease. Our data demonstrate that patients with less than GTR and <3 years at diagnosis are at increased risk for progression and may benefit from more aggressive therapy.
