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[Astrocytomas in pediatrics. The prognostic factors and survival]
E López-Aguilar1, F Cerecedo-Díaz, A C Sepúlveda-Vidosoĺa
1Servicio de Oncología, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F.
Insights
Pediatric astrocytomas, a common brain tumor, show better survival rates when low-grade and located supratentorial or cerebellar. Brain stem astrocytomas and high-grade tumors indicate a poorer prognosis for children.
Area of Science:
- Pediatric oncology
- Neuro-oncology
- Cancer epidemiology
Context:
- Central nervous system (CNS) tumors are the second most common pediatric malignancy.
- Astrocytomas represent the majority of these childhood brain tumors.
- Understanding prognostic factors is crucial for treatment planning and patient outcomes.
Purpose:
- To investigate the impact of various factors on the survival of pediatric astrocytoma patients.
- To analyze the influence of tumor location, grade, age, and sex on patient prognosis.
- To identify key indicators for improved survival in childhood astrocytomas.
Summary:
- A review of 39 pediatric astrocytoma cases from 1984-1995 analyzed survival data.
- Tumor location (supratentorial/cerebellar vs. brain stem) and grade (low vs. high) significantly affected prognosis.
- Low-grade astrocytomas and those in supratentorial or cerebellar locations demonstrated better survival outcomes.
Impact:
- Identifies specific astrocytoma characteristics associated with improved pediatric survival.
- Provides evidence supporting the importance of tumor location and grade in predicting outcomes.
- Informs clinical decision-making and research priorities in pediatric neuro-oncology.
Abstract:
Tumors of the central nervous system are the second most frequent malignancy in children under the age of 15 the majority of which are astrocytomas. The purpose of this paper is to analyze the effect of some factors on the survival of patients with astrocytomas. We reviewed the clinical charts of patients with a diagnosis of astrocytoma from 1984 to 1995 and we analyzed the age, sex, location, malignant grade and survival according to the actuarial method and log rank tests. A total of 39 patients were detected, 43% were supratentorial, 13% cerebellar and 43% from the brain stem. There was a better prognosis for those located supratentorial or cerebellar with respect to those in the brain stem, with statistical significance. The treatment consisted in surgical resection in 26 patients, 17 of which were found to have a high grade of malignancy and 9 with low grade, with statistically better prognosis for low grade tumors. There were 17 deaths during the period, with 8 of these patients having a high grade tumor a 10, with brain stem tumors. Forty-one percent of the patients that died did so in the first year and 94% during the first two years after diagnosis. Patients with cerebellar astrocytoma and patients with low-grade astrocytomas had the best prognosis.