Pilocytic astrocytomas in children: Prognostic factors - A retrospective study of 80 cases

被引:176
作者
Fernandez, C
Figarella-Branger, D
Girard, N
Bouvier-Labit, C
Gouvernet, J
Paredes, AP
Lena, G
机构
[1] Hop La Timone, Serv Neuroradiol, Marseille, France
[2] Hop La Timone, Serv Informat Med, Marseille, France
[3] Hop La Timone, Serv Anat Pathol & Neuropathol, F-13385 Marseille 05, France
[4] Hop La Timone, Serv Neurochirurg Pediat, Marseille, France
关键词
brain tumor; child; pilocytic astrocytomas; pilomyxoid astrocytoma; prognostic factors;
D O I
10.1227/01.NEU.0000079330.01541.6E
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
OBJECTIVE: Pilocytic astrocytomas (PA) are Grade I brain tumors characterized by an excellent prognosis. In some cases, however, the patient has a bad outcome. The aim of our study was to search for the clinicopathological factors underlying the prognosis for patients with this disease. METHODS: We reviewed the clinical, neuroradiological, and histopathological features of 80 PAs, (33 cerebellar, 18 optochiasmatic, 16 brainstem, 7 spinal cord, 3 thalamic, 2 optic nerve, and 1 hemispheric) in pediatric patients. RESULTS: Pathological examination revealed 58 classic PAs and 20 pilomyxoid astrocytomas, which are a histological variant of PAS. Two cases remained unclassified. The mean overall follow-up period was 58 months, the 5-year progression-free survival rate was 75%, and the 5-year survival rates were 100 and 92% after total and partial removal. Univariate statistical analysis revealed that partial resection, optochiasmatic PA localization, and pilomyxoid variant were associated with a worse prognosis, but the latter two were too closely related to the extent of resection to be independent prognostic factors in multivariate analysis. Among the patients who underwent partial surgical removal, only invasion of the surrounding structures was related to prognosis. CONCLUSION: PAs are benign tumors, but some clinicopathological factors, such as partial resection, optochiasmatic location, invasion of surrounding structures, and the pilomyxoid variant, have a worse prognosis.
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收藏
页码:544 / 553
页数:10
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