Prognosis of cerebellar astrocytomas in children
- 131 Downloads
Our main objective is to review a large series of cerebellar astrocytomas in children and evaluate the outcome of the patients depending on astrocytoma class. The effect of astrocytoma characteristics on the children’s prognosis was determined by grouping a series of cerebellar astrocytomas by their location, radiological aspect, size, and histology and determining whether this was related with outcome.
Materials and methods
Two hundred and three children with cerebellar astrocytomas were retrospectively reviewed, and their tumors were classified by location, macroscopic radiological appearance, size, and histology. We have distinguished between patients operated before and after 1974 because of the introduction of new diagnostic (computed tomography, magnetic resonance) and more sophisticated treatment techniques after this year (microsurgery, laser, cavitron, etc).
Our patients’ results were classified according to the Lapras scale/classification as normal, with some neurological deficit but able to lead a normal life, and those with severe post surgical deficits. Recurrences and mortality were also noted. Normal or good results were obtained in 111 patients, some neurological deficit in 55, and severe deficits in nine. There were six recurrences and 22 deaths because of the disease.
Two main factors affected prognosis. One was whether the tumor was completely resected or not; this was the treatment in most cases in this series. The second factor was the location, size, and macroscopic appearance of the tumor. The best prognosis was associated with being located in one hemisphere, being cystic, being cystic with a posterior nodule, and/or being small.
KeywordsCerebellar Astrocytomas CT Hydrocephalus MR Posterior fossa
- 1.Alpers CE, Davis RL, Wilson CB (1982) Persistence and late malignant transformation of childhood cerebellar astrocytoma. J Neurosurg 57:648–655Google Scholar
- 3.Bernell WR, Kepes JJ, Seitz EP (1973) Late malignant recurrence of childhood cerebellar astrocytoma. Report of two cases. J Neurosurg 37:470–474Google Scholar
- 4.Bucy PC, Thieman PW (1984) Astrocytomas of the cerebellum: a study of a series of patients operated upon over 28 years old. Arch Neurol 18:14–19Google Scholar
- 6.Crawford JV, Rubinstein LW, Rusell DS (1958) Follow up of cerebellar astrocytoma in relation to their pathology. J Neurol Neurosurg Psychiatry 21:64Google Scholar
- 7.Cushing H (1931) Experiences with the cerebellar astrocytomas, a critical review of seventy-six cases. Surg Gynecol Obstet 52:129–204Google Scholar
- 10.Elridge AR (1968) Long term survival in the astrocytomas series. J Neurosurg 28:399–404Google Scholar
- 25.Rallel C, Edwards MSB, Davis RL et al (1985) Post-irradiation cerebellar glioma. J Neurosurg 62:300–302Google Scholar
- 28.Scott RM, Ballantine HT (1972) Malignant recurrence after prolonged postoperative survival. J Neurosurg 39:777–779Google Scholar