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Differences in the clinical courses of pediatric and adult pilocytic astrocytomas with progression: a single-institution study

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Abstract

Purpose

Pilocytic astrocytoma (PA) is a World Health Organization grade I neoplasm that generally follows a benign course. However, in some patients, PA exhibits an aggressive clinical course. Here, we examined the clinical course of pediatric and adult PAs with progression at a single institution.

Methods

Between 1995 and 2013, 39 patients with PA were treated. Nineteen were pediatric patients (mean age, 12 years; range, 1–17 years) with a male-to-female patient ratio of 10:9, while 20 were adults (mean age, 36.4 years; range, 19–65 years) with a male-to-female ratio of 9:11. We analyzed and compared tumor location, extent of tumor resection, adjuvant treatment, and clinical course in all patients.

Results

In the 19 pediatric patients, tumors were located in the cerebellar vermis, cerebellar hemisphere, optic pathways plus hypothalamus, hypothalamus, brainstem, and the temporal lobe in 6 (31.6 %), 5 (26.3 %), 3 (15.8 %), 2 (10.5 %), and 2 (10.5 %) patients and 1 (5.3 %) patient, respectively. The mass was totally, subtotally, or partially resected in 11 (57.9 %), 2 (10.5 %), and 4 (21.1 %) patients, respectively; biopsies were performed in 2 (10.5 %) patients. Immediate postoperative adjuvant treatment was carried out in 6 patients. Tumor progression was detected in 3 patients at 3.0, 4.6, and 5.2 years after treatment, respectively, without significant symptoms. In the 20 adult patients, tumors were located in the cerebellar hemisphere, cerebellar vermis, hypothalamus, brainstem, cerebral hemisphere, and lateral ventricle in 5 (25 %), 4 (20 %), 3 (15 %), 3 (15 %), 3 (15 %), and 2 (10 %) patients, respectively. The mass was totally, subtotally, or partially resected in 11 (55 %) and 6 (30 %) patients and 1 (5 %) patient, respectively; biopsies were performed in 2 patients. Immediate adjuvant treatment was carried out in 2 patients. Progression was detected in 3 patients at 0.3, 0.9, and 2.5 years after treatment, respectively, with progressive neurologic symptoms. There was one case of disease-related mortality during follow-up among the adult patients.

Conclusion

Most of the PA cases evaluated in this study were benign. However, tumor progression in adult PAs followed a more aggressive clinical course than those in pediatric PAs.

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Acknowledgments

This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Science, ICT and Future Planning (2014R1A1A1004469).

Conflict of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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Authors and Affiliations

  1. Brain Tumor Research Laboratory, Chonnam National University Hwasun Hospital, 160, Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanam-do, 519-809, Republic of Korea

    Hyang-Hwa Ryu

  2. Department of Neurosurgery, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, 160, Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanam-do, 519-809, Republic of Korea

    Tae-Young Jung, Gwang-Jun Lee, Seung-Hoon Jung & Shin Jung

  3. Department of Pathology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Gwangju, South Korea

    Kyung-Hwa Lee

  4. Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Gwangju, South Korea

    Hee-Jo Baek

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  1. Hyang-Hwa Ryu
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  2. Tae-Young Jung
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  5. Seung-Hoon Jung
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Correspondence to Tae-Young Jung.

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Ryu, HH., Jung, TY., Lee, GJ. et al. Differences in the clinical courses of pediatric and adult pilocytic astrocytomas with progression: a single-institution study. Childs Nerv Syst 31, 2063–2069 (2015). https://doi.org/10.1007/s00381-015-2887-z

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  • DOI: https://doi.org/10.1007/s00381-015-2887-z

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