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Low-grade gliomas in children: single institutional experience in 198 cases

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Abstract

Introduction

In pediatric population (0–18 years), low-grade gliomas (PLGG) are the most frequent brain tumors and majority are amenable for surgical removal.

Patients and methods

A retrospective review of 198 children diagnosed with PLGG between 1980 and 2010 at HSJD was carried out. Several variables were studied to find prognostic factors related to the outcomes (progression-free survival (PFS) and overall survival (OS)).

Results

Median age at onset was 88.8 months (3.1 to 214.5 months, SD 53). Surgery was performed in 175 patients (88.4 %), achieving gross total resection (GTR) in 77 (44 %), subtotal resection (STR) in 87 (49.7 %), and 11 (6.3 %) biopsies. Pathological review classified 84 tumors as WHO grade I (48 %) and 89 as grade II (50.8 %). Adjuvant therapy (AT) was given to 75 patients (37.9 %), radiotherapy in 24 (12.1 %), chemotherapy in 33 (16.7 %), and combined in 18 (9.1 %). Sixteen patients (8.1 %) died, 89 (43.4 %) are alive with no evidence of disease, and 93 (47 %) alive with disease, median follow-up 65.2 months. Outcome is significantly correlated with age (p = 0001, worse OS for patients younger than 12 months) and extent of tumor resection (p < 0001). OS for GTR/STR/biopsy was >200, 154.3, and 101.9 months, respectively. Patients treated with AT presented worse OS/PFS (p < 0.001) than those not treated. Histology was non significantly related to outcomes.

Conclusion

In our series of PLGG, the best prognostic markers are tumor location (cerebellar) and the extent of tumor resection (GTR). Infants and patients who require adjuvant therapy because of tumor progression or recurrence have worse outcome.

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Acknowledgments

We are grateful to our nursing and multidisciplinary staff for their support in patient care. We thank Daniel Cuadras and Sara Perez Jaume for their support in statistics (Fundació Sant Joan de Déu per la recerca). The authors also thank the institutional Biobank “Biobanc de l’ Hospital Materno-Infantil de Sant Joan de Déu per la recerca” as part of the “Red Temática de  Biobancos Hospitalarios del ISCIII” and also Miss Sarah Buttler for her valuable help in the edition of this paper.

Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Department of Neurosurgery, Hospital Sant Joan de Déu, University of Barcelona, Passeig St. Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain

    Magda Garzón & Gemma García-Fructuoso

  2. Department of Pathology, Hospital Sant Joan de Déu, University of Barcelona, Passeig St. Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain

    Mariona Suñol

  3. Department of Oncology, Hospital Sant Joan de Déu, University of Barcelona, Passeig St. Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain

    Jaume Mora & Ofelia Cruz

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  1. Magda Garzón
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  3. Mariona Suñol
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Correspondence to Magda Garzón or Ofelia Cruz.

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Garzón, M., García-Fructuoso, G., Suñol, M. et al. Low-grade gliomas in children: single institutional experience in 198 cases. Childs Nerv Syst 31, 1447–1459 (2015). https://doi.org/10.1007/s00381-015-2800-9

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  • DOI: https://doi.org/10.1007/s00381-015-2800-9

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