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Risk assessment in paediatric glioma-Time to move on from the binary classification
A J Dodgshun1, J R Hansford2, M J Sullivan2
1Children's Haematology/Oncology Centre, Christchurch Hospital, Christchurch, New Zealand; Department of Paediatrics, University of Otago (Christchurch), Christchurch, New Zealand.
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.
