Prognostic Factors in Management of Primary Spinal Cord Astrocytoma in ChildrenElizabeth Goodman1, Mark Krieger, MD1, Yasser Jeelani, MD1, Caleb Standafer1, J. McComb, MD11Philadelphia, PA United States Keywords: children, risk factor, outcome, spinal cord, astrocytoma
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. Project Roles:
E. Goodman (), M. Krieger (), Y. Jeelani (), C. Standafer (), J. McComb ()