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Benign cerebellar astrocytomas in children
P Pencalet1, W Maixner, C Sainte-Rose
1Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades, Paris, France.
Journal of Neurosurgery
|February 9, 1999
Summary
Brainstem involvement in pediatric cerebellar astrocytomas is a negative prognostic factor. Complete surgical resection is crucial for reducing tumor recurrence and improving patient outcomes.
Area of Science:
- Pediatric neurosurgery
- Pediatric oncology
- Tumor biology
Background:
- Cerebellar astrocytomas are common pediatric brain tumors.
- Complete surgical resection offers excellent survival rates.
- Prognostic factors beyond resection completeness require clarification.
Purpose of the Study:
- To investigate clinical, radiological, histological, and therapeutic factors influencing survival, recurrence, and outcomes in pediatric cerebellar astrocytomas.
- To identify specific prognostic indicators for these tumors.
Main Methods:
- Retrospective review of 168 children surgically treated for cerebellar astrocytoma (1955-1995).
- Analysis of clinical data, histological characteristics, and long-term outcomes (neurological status, intelligence quotient).
- Multivariate analysis to determine significant prognostic factors.
Main Results:
- Complete surgical excision was achieved in 88.7% of cases.
- Mortality rate was 4.2%, and tumor recurrence rate was 9.5%.
- Negative prognostic factors identified: prolonged pre-operative symptoms, brainstem involvement (transitional form), incomplete resection, early surgical era, and severe ventricular dilation.
Conclusions:
- Brainstem involvement (transitional form) is a significant negative prognostic factor and warrants distinct classification.
- Extent of surgical excision directly impacts the risk of tumor recurrence.
- Optimizing surgical strategy and recognizing specific tumor subtypes are key for improved pediatric cerebellar astrocytoma management.