Prognostic Factors in Management of Primary Spinal Cord Astrocytoma in ChildrenKeywords: children, risk factor, outcome, spinal cord, astrocytomaInteractive Manuscript
Ask Questions of this Manuscript:
What is the background behind your study?
Astrocytomas are the most common primary intramedullary spinal neoplasms in children.
What is the purpose of your study?
Scant data exists regarding prognostic factors and efficacy of treatment modalities.
Describe your patient group.
This IRB-approved study retrospectively reviewed 38 children with primary spinal astrocytomas presenting from June 1981 to June 2011.
Describe what you did.
Multi-factorial analyses examined the following factors’ prognostic value on progression-free survival: symptom type and duration; tumor location, size, and grade; extent of resection; chemotherapy; and radiation.
Describe your main findings.
Tumors included 5 pilocytic astrocytomas, 20 low-grade astrocytomas, and 13 anaplastic astrocytomas. 14 patients received biopsy only, 17 underwent partial resection, and 7 had gross total resection. Median age at resection was 124 months (range 16-204). Median follow-up was 45 months (range 1-396). 16 children received chemotherapy. 22 received radiation. Overall and progression-free survivals were 94.7% and 71.1% respectively at 6 months. Anaplastic astrocytomas and age over 7 years independently had significantly worse progression-free survival (p = 0.003, p = 0.008 respectively). Extent of resection showed benefit in low-grade tumors only (p = 0.048).
Describe the main limitation of this study.
This is a retrospective study.
Describe your main conclusion.
Anaplastic histology and age over 7 were associated with worse progression-free survival.
Describe the importance of your findings and how they can be used by others.
Extent of resection was associated with increased progression-free survival in low-grade tumors.
Astrocytomas are the most common primary intramedullary spinal neoplasms in children.
Scant data exists regarding prognostic factors and efficacy of treatment modalities.
This IRB-approved study retrospectively reviewed 38 children with primary spinal astrocytomas presenting from June 1981 to June 2011.
Multi-factorial analyses examined the following factors’ prognostic value on progression-free survival: symptom type and duration; tumor location, size, and grade; extent of resection; chemotherapy; and radiation.
Tumors included 5 pilocytic astrocytomas, 20 low-grade astrocytomas, and 13 anaplastic astrocytomas. 14 patients received biopsy only, 17 underwent partial resection, and 7 had gross total resection. Median age at resection was 124 months (range 16-204). Median follow-up was 45 months (range 1-396). 16 children received chemotherapy. 22 received radiation. Overall and progression-free survivals were 94.7% and 71.1% respectively at 6 months. Anaplastic astrocytomas and age over 7 years independently had significantly worse progression-free survival (p = 0.003, p = 0.008 respectively). Extent of resection showed benefit in low-grade tumors only (p = 0.048).
This is a retrospective study.
Anaplastic histology and age over 7 were associated with worse progression-free survival.
Extent of resection was associated with increased progression-free survival in low-grade tumors.
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