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Hemispheric supratentorial astrocytomas in children. Long-term results in 29 cases
Insights
Pediatric hemispheric supratentorial astrocytomas (HSAs) are generally benign, with a 76% survival rate in a long-term study. Cystic and pilocytic types showed the best outcomes for children with these rare brain tumors.
Area of Science:
- Pediatric neuro-oncology
- Neurosurgery
- Neuropathology
Background:
- Hemispheric supratentorial astrocytomas (HSAs) are rare brain tumors in children.
- Understanding the long-term prognosis and characteristics of pediatric HSAs is crucial for treatment planning.
Purpose of the Study:
- To evaluate the long-term outcomes and survival rates of pediatric hemispheric supratentorial astrocytomas (HSAs).
- To identify prognostic factors influencing survival and quality of life in children with HSAs.
Main Methods:
- Retrospective analysis of 41 pediatric hemispheric supratentorial astrocytoma (HSA) cases.
- Long-term follow-up (5-27 years) of 29 patients.
Main Results:
- A 76% survival rate (22 out of 29 patients) was observed, with a mean survival of 13.3 years.
- Cystic and pilocytic HSAs demonstrated the best outcomes regarding survival and quality of life.
- Tumor recurrence leading to death occurred within 4 years, predominantly in patients operated on before age 8.
Conclusions:
- Pediatric hemispheric supratentorial astrocytomas (HSAs) exhibit a relatively benign clinical course.
- Cystic, pilocytic HSAs in children share favorable prognostic similarities with cerebellar astrocytomas.
Abstract:
In a series of 41 cases of hemispheric supratentorial astrocytoma (HSA) in children, 29 patients have been followed for periods ranging from 5 to 27 years. The follow-up data show that HSA's are relatively benign tumors. Twenty-two patients (76%) are still living: 12 in good, eight in fair, and two in poor neurological condition. Their mean survival is 13.3 years. Five patients died from tumor recurrence within 4 years of the operation. All five were operated on before the age of 8 years. The best results in terms of mean survival and quality of life were obtained in cases of cystic HSA, especially the pilocytic variety. In children, HSA tends to take the cystic form (often pilocytic), and its relatively benign course points up an analogy between this rare supratentorial tumor and the more common tumor of the cerebellum (the so-called "cerebellar astrocytoma").