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Surveillance imaging in children with primitive neuroectodermal tumors
1Division of Neurological Surgery, Children's Hospital Los Angeles, University of Southern California, USA.
Neurosurgery
|April 1, 1996
Summary
Routine surveillance imaging for pediatric primitive neuroectodermal tumors (PNETs) can detect recurrences early in asymptomatic children. Early detection via imaging offers a therapeutic window, improving survival compared to symptomatic detection.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Diagnostic Imaging
Background:
- Controversy exists regarding the utility of routine surveillance imaging (MRI/CT) for detecting recurrences in children with primitive neuroectodermal tumors (PNETs).
- Previous studies suggested limited value, noting that imaging detects few symptomatic recurrences and offers poor survival even when recurrences are identified.
Purpose of the Study:
- To evaluate the effectiveness of routine surveillance imaging in detecting tumor recurrence in pediatric patients with PNETs.
- To compare survival outcomes between asymptomatic and symptomatic children diagnosed with recurrent PNETs via surveillance imaging.
Main Methods:
- Retrospective review of 25 pediatric patients with recurrent PNETs treated between 1985 and 1993.
- Analysis of tumor recurrence detection by routine imaging in asymptomatic versus symptomatic patients.
- Comparison of time to recurrence and survival rates based on detection method and symptom status.
Main Results:
- Recurrent PNETs were detected by routine imaging in 19 asymptomatic (76%) and 6 symptomatic (24%) patients.
- Recurrence was diagnosed significantly earlier in asymptomatic children (15 months mean) compared to symptomatic children (5 months mean).
- Asymptomatic patients with recurrences detected via imaging demonstrated prolonged survival compared to symptomatic patients, with survivors living >24 months post-recurrence.
Conclusions:
- Early detection of PNET recurrence through surveillance imaging in asymptomatic children provides a critical window for intervention.
- Routine surveillance imaging may offer a clinical benefit by enabling timely treatment, potentially improving survival outcomes in pediatric PNET patients.