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Is the Knowledge Pertaining to Adult Glioblastomas Enough for Pediatric Cases? Prognostic Factors in Childhood
Burcak Bilginer1, Sahin Hanalioglu, Cezmi Cagri Turk
1Hacettepe University, School of Medicine, Department of Neurosurgery, Ankara, Turkey.
Insights
Pediatric glioblastoma (GBM) outcomes are influenced by tumor location and resection extent. Early detection of metastases and gross total resection are crucial for improving survival in children with GBM.
Area of Science:
- Pediatric neuro-oncology
- Neurosurgery
- Radiation oncology
Background:
- Pediatric glioblastoma (GBM) remains a challenging pediatric brain tumor with limited understanding of its clinical, radiological, and pathological features.
- Prognostic factors for pediatric GBM are not well-defined, necessitating further investigation.
Purpose of the Study:
- To explore the clinical, radiological, and pathological characteristics of pediatric glioblastoma.
- To identify prognostic factors influencing outcomes in pediatric GBM patients.
Main Methods:
- Retrospective analysis of a database of 42 pediatric patients with histologically confirmed GBM.
- Review of clinical, radiological, and pathological data to identify prognostic factors.
Main Results:
- The study included 42 patients (20 boys, 22 girls) with a mean age of 10.2 years.
- Most tumors (97.6%) were supratentorial, with lobar/hemispheric locations being most common (68.3%).
- Seeding metastases were present in 11/42 children. Gross total resection (GTR) was achieved in 30.9% of patients. Median progression-free survival was 7.0 months, and median overall survival was 11.0 months.
Conclusions:
- Gross total resection (GTR) is a feasible and recommended surgical goal in pediatric GBM.
- Frequent radiological evaluation of the entire neuraxis is essential for detecting seeding metastases at diagnosis and during follow-up.
Aim:
Pediatric glioblastoma (GBM) is still a topic obscurity. The aim of this study was to explore clinical, radiological and pathological features, and prognostic factors affecting the outcomes.
Material And Methods:
We retrospectively reviewed our database for prognostic factors for 42 consecutive pediatric patients with histologically proven GBM treated in our hospital.
Results:
The study reached at 20 boys and 22 girls, with a mean age of 10.2 years. Almost all patients (97.6%) had supratentorial tumors; lobar/hemispheric (68.3%), thalamic (26.8%) and suprasellar-hypothalamic region (4.8%). Total of 11/42 children had seeding metastases (mean 11.5 months) either preoperatively or postoperatively. Gross total resection (GTR) was achieved in 13 patients (30.9%) in the first surgery. Perioperative mortality and morbidity rates were 4.7% and 19%, respectively. Patients were followed for an average of 18.1 months. The median progression-free and overall survivals were 7.0 (95% CI: 5.9-8.0) and 11.0 (95% CI: 8.9-13.1) months, respectively. 1-year, 2-year and 5-year progression-free survival and overall survivals were 30.9% vs. 50.0%, 11.9% vs. 19.0%, 4.8% vs. 9.5%; respectively.
Conclusion:
Gross total resection should be safely attempted in pediatric GBM. In addition, a thorough and frequent radiological evaluation of the entire neuraxis for seeding metastases is recommended both at diagnosis and follow-ups.
