Cervicomedullary tumors in children.
J Neurosurg Pediatr
; 16(4): 357-66, 2015 Oct.
Article
em En
| MEDLINE
| ID: mdl-26114990
ABSTRACT
OBJECT Cervicomedullary tumors (CMTs) represent a heterogeneous group of intrinsic neoplasms that are typically low grade and generally carry a good prognosis. This single-institution study was undertaken to document the outcomes and current treatment philosophy for these challenging neoplasms. METHODS:
The charts of all pediatric patients with CMTs who received treatment at St. Jude Children's Research Hospital between January 1988 and May 2013 were retrospectively reviewed. Demographic, surgical, clinical, radiological, pathological, and survival data were collected. Treatment-free survival and overall survival were estimated, and predictors of recurrence were analyzed.RESULTS:
Thirty-one children (16 boys, 15 girls) with at least 12 months of follow-up data were identified. The median age at diagnosis was 6 years (range 7 months-17 years) and the median follow-up was 4.3 years. Low-grade tumors (Grade I or II) were present in 26 (84%) patients. Thirty patients underwent either a biopsy alone or resection, with the majority of patients undergoing biopsy only (n = 12, 39%) or subtotal resection (n = 14, 45%). Only 4 patients were treated solely with resection; 21 patients received radiotherapy alone or in combination with other treatments. Recurrent tumor developed in 14 children (45%) and 4 died as a result of their malignancy. A high-grade pathological type was the only independent variable that predicted recurrence. The 5- and 10-year treatment-free survival estimates are 64.7% and 45.3%, respectively. The 5- and 10-year overall survival estimate is 86.7%.CONCLUSIONS:
Children with CMTs typically have low-grade neoplasms and consequently long-term survival, but high risk of recurrence. Therapy should be directed at achieving local tumor control while preserving and even restoring neurological function.Palavras-chave
CMT = cervicomedullary tumor; GBM = glioblastoma multiforme; GTR = gross-total resection; HGG NOS = high-grade glioma, not otherwise specified; NTR = near-total resection; OS = overall survival; PD = progressive disease; RT = radiotherapy; SD = stable disease; STR = subtotal resection; TFS = treatment-free survival; cervicomedullary tumor; chemotherapy; low-grade neoplasm; oncology; outcomes; radiation; resection
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Medula Espinal
/
Neoplasias do Tronco Encefálico
/
Glioma
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Idioma:
En
Revista:
J Neurosurg Pediatr
Assunto da revista:
NEUROCIRURGIA
/
PEDIATRIA
Ano de publicação:
2015
Tipo de documento:
Article