Survival and Prognostic Factors in Children with Brain Tumors: Long-term Follow-up Single Center Study in Poland

Aim: Analysis of risk factors for survival in long-term follow-up of children treated at a single pediatric center in Poland. Patients and Methods: Out of 623 children diagnosed with cancer between 1995-2005, 110 were treated for brain tumors and followed-up, with a mean survival of 11.4 years. Results: Overall 5-year survival in the whole cohort was 60.9 +/- 4.7%, while 10-year survival was 58.2 +/- 4.7%. No relapse, progression or death occurred after six years from initial diagnosis. Survival was 48.1 +/- 9.6% for patients with medulloblastoma and primitive neuroectodermal tumors; 83.3 +/- 6.2% for low-grade astrocytoma; 56.6 +/- 16.6% for ependymoma, while 0% at 72 months for high-grade glioma. Patients with cerebellar tumors had a survival rate 69.0 +/- 7.1% at 10 years. Multivariate analysis showed that factors predicting poor outcome were: grade III-IV tumor, incomplete surgical resection, and complications after surgical resection, while diagnosis of low-grade glioma was the only factor predicting good outcome. Progression of the disease during therapy was an additional independent adverse risk factor for survival. Conclusion: Long-term survival was achieved by 58% of children with brain tumors. Advanced tumor stage, incomplete surgical resection, complications of surgical treatment, and progression of the disease during treatment predicted poor outcome.