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Primary spinal cord tumors of childhood: effects of clinical presentation, radiographic features, and pathology on survival

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Abstract

To determine the relationship between clinical presentation, radiographic features, pathology, and treatment on overall survival of newly diagnosed pediatric primary spinal cord tumors (PSCT). Retrospective analysis of all previously healthy children with newly diagnosed PSCT at a single institution from 1995 to present was performed. Twenty-five pediatric patients (15 boys, average 7.9 years) were diagnosed with PSCT. Presenting symptoms ranged from 0.25 to 60 months (average 7.8 months). Symptom duration was significantly shorter for high grade tumors (average 1.65 months) than low grade tumors (average 11.2 months) (P = 0.05). MRI revealed tumor (8 cervical, 17 thoracic, 7 lumbar, 7 sacral) volumes of 98–94,080 mm3 (average 19,474 mm3). Homogeneous gadolinium enhancement on MRI correlated with lower grade pathology (P = 0.003). There was no correlation between tumor grade and volume (P = 0.63) or edema (P = 0.36) by MRI analysis. Median survival was 53 months and was dependent on tumor grade (P = 0.05) and gross total resection (P = 0.01) but not on gender (P = 0.49), age of presentation (P = 0.82), duration of presenting symptoms (P = 0.33), or adjuvant therapies (P = 0.17). Stratified Kaplan–Meier analysis confirmed the association between degree of resection and survival after controlling for tumor grade (P = 0.01). MRI homogeneous gadolinium enhancement patterns may be helpful in distinguishing low grade from high grade spinal cord malignancies. While tumor grade and gross total resection rather than duration of symptoms correlated with survival in our series, greater than one-third of patients had reported symptoms greater than 6 months duration prior to diagnosis.

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Abbreviations

CNS:

Central nervous system

PSCT:

Primary spinal cord tumor

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Acknowledgements

This work was supported by the National Institutes of Health Neurological Sciences Academic Development Award (NSADA) K12NS052159-01A1.

Open Access

This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

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Authors and Affiliations

  1. Department of Neurology, Children’s National Medical Center, The George Washington University, Washington, DC, USA

    John R. Crawford & Roger J. Packer

  2. Department of Radiology, Children’s National Medical Center, The George Washington University, Washington, DC, USA

    Alejandra Zaninovic, Gilbert Vezina & Nadja Kadom

  3. Department of Pathology, Children’s National Medical Center, The George Washington University, Washington, DC, USA

    Mariarita Santi & Robert F. Keating

  4. Department of Neurosurgery, Children’s National Medical Center, The George Washington University, Washington, DC, USA

    Mariarita Santi & Robert F. Keating

  5. The Brain Tumor Institute, Children’s National Medical Center, The George Washington University, Washington, DC, USA

    John R. Crawford, Robert F. Keating, Gilbert Vezina, Nadja Kadom & Roger J. Packer

  6. The Department of Neuropathology and Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, DC, USA

    Elisabeth J. Rushing

  7. The Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Cara H. Olsen

  8. University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0662, USA

    John R. Crawford

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  1. John R. Crawford
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Correspondence to John R. Crawford.

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Crawford, J.R., Zaninovic, A., Santi, M. et al. Primary spinal cord tumors of childhood: effects of clinical presentation, radiographic features, and pathology on survival. J Neurooncol 95, 259–269 (2009). https://doi.org/10.1007/s11060-009-9925-1

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  • DOI: https://doi.org/10.1007/s11060-009-9925-1

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