Prognostic factors in pediatric spinal cord astrocytoma.

Abstract:

BACKGROUND:Factors that could optimize the management of pediatric spinal cord astrocytoma remain unclear and controversial. METHODS:To determine the factors that influence the prognosis of pediatric patients with spinal cord astrocytomas, a series of 73 consecutive patients at 13 French treatment centers with histologically proven spinal cord astrocytomas was retrospectively reviewed. Hospital records, operative records, and results of radiologic investigations were available in all cases. Follow-up was achieved in 94% of cases. RESULTS:Seventy percent of the patients had low grade (1 or 2) tumors. Total or subtotal surgical resection was achieved in 43%. Thirty-six patients were irradiated following surgery. Fifty-one patients were alive at a median follow-up of 54 months. Twenty-three patients relapsed. Univariate analysis showed that good outcome was correlated with male gender, age younger than 7 years, duration of presenting symptoms longer than 2 months, the presence of spinal deformities, and low grade histology, whereas sensory loss was associated with decreased survival. Multivariate analysis using the Cox proportional hazards model confirmed that histology (relative risk [RR] = 7.69) and the interval between first symptoms and diagnosis (RR = 4.93) were significant independent prognostic factors. The extent of surgery or radiotherapy had no clear influence on survival. CONCLUSIONS:This review sheds light on the prognoses of pediatric patients with spinal cord astrocytomas and may help to determine therapeutic strategies based on patients' clinical, radiologic, and pathologic features.

journal_name

Cancer

journal_title

Cancer

authors

Bouffet E,Pierre-Kahn A,Marchal JC,Jouvet A,Kalifa C,Choux M,Dhellemmes P,Guérin J,Tremoulet M,Mottolese C

doi

10.1002/(sici)1097-0142(19981201)83:11<2391::aid-c

subject

Has Abstract

pub_date

1998-12-01 00:00:00

pages

2391-9

issue

11

eissn

0008-543X

issn

1097-0142

pii

10.1002/(SICI)1097-0142(19981201)83:11<2391::AID-C

journal_volume

83

pub_type

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