Cerebellar pilocytic astrocytoma in childhood: Investigating the long-term impact of surgery on cognitive performance and functional outcome

Pletschko, Thomas; Felnhofer, Anna; Lamplmair, Doris; Dorfer, Christian; Czech, Thomas; Chocholous, Monika; Slavc, Irene; Leiss, Ulrike

doi:10.1080/17518423.2017.1370502

Cited by 22 publications

(34 citation statements)

References 26 publications

(54 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The adult patients showed no signs of psychosocial difficulties and had an educational situation comparable to the general population in Sweden [ 34 ], which is also reported in other studies [ 15 , 23 ]. However, in a study by Pletschko et al [ 35 ] patients treated for cerebellar pilocytic astrocytoma showed satisfactory academic achievement, but when they were compared with high achievers (i e medical students) specific cognitive impairments became apparent. This underscores our findings in the interviews, that as much as one-third of the patients reported learning difficulties that were not dealt with in school, despite the fact that some of these difficulties had been diagnosed in neuropsychological investigations.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics, long-term complications and health-related quality of life (HRQoL) in children and young adults treated for low-grade astrocytoma in the posterior fossa in childhood

et al. 2019

View full text Add to dashboard Cite

Introduction Pilocytic astrocytoma is the most common brain tumour in childhood but knowledge concerning its long-term outcome is sparse. The aim of the study was to investigate if children treated for low-grade pilocytic astrocytoma in the posterior fossa had complications affecting physical and psychological health, cognitive functions, learning difficulties and HRQoL. Methods A descriptive single-centre study, where 22 children and young adults out of 27 eligible patients (81%) treated for pilocytic astrocytoma, with a mean follow-up time of 12.4 years (5–19 years) participated (14 adults, two by telephone interviews and eight children). The study included a review of medical records, an interview, neurological investigation, screening tools for psychiatric symptoms (Beck Depression and Anxiety Inventories and Beck Youth Inventory Scales) and HRQoL measures (RAND-36). Results Motor complications were most common, reported in 12 patients and mainly affecting fine-motor skills. Seven patients reported cognitive difficulties affecting performance in school. Educational support was given in the period immediately after treatment but not after primary school. None had elevated levels of psychiatric symptoms and the level of HRQoL as well as their psychosocial and educational situation was in correspondence with Swedish norms. The HRQoL score for vitality (VT) almost reached statistical significance. Conclusions The long-term functional outcome for children treated for low-grade astrocytoma is favourable. However, some patients report neurological complications and learning difficulties, which are unmet in school. Therefore, there is a need to identify those who need more thorough medical and cognitive follow-up programmes including interventions in school.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical characteristics, long-term complications and health-related quality of life (HRQoL) in children and young adults treated for low-grade astrocytoma in the posterior fossa in childhood

et al. 2019

View full text Add to dashboard Cite

show abstract

“…In view of the heterogeneous spectrum of pediatric LGG with respect to age, NF1 status, tumor site, and treatment, results of limited patient numbers have to be interpreted with caution for significance. 15 , 17 , 26 Analysis of neuropsychological sequelae has to implement distinct cognitive outcome variables apart from full-scale IQ score, which are essential for the quality of survival (QoS) and neuropsychological functioning, while remaining brief in execution. 28 Otherwise, smaller centers may have problems to implement full neuropsychological assessment due to restricted resources.…”

Section: Discussionmentioning

confidence: 99%

“… 5 Survivors were found to be at risk for deficits in neuropsychological dimensions such as attention, processing speed, executive functioning, visual-spatial memory, language, and verbal short-term memory over time. 14 Although some studies proved good functional outcomes without severe quality of life (QoL) issues and few neurocognitive differences when comparing patients after treatment of cerebellar pilocytic astrocytoma to the healthy norm, 15–17 impairments were detected when comparing LGG patients to high-achieving peers 17 or their siblings. 13 …”

mentioning

confidence: 99%

“…Nearly 1 of 2 patients meets the criteria for attention-deficit hyperactivity disease. 25 Interpretation of results from cognitive testing of LGG patients is often hampered by small patient series, widespread diagnostic time points, 17 , 24 , 26 or variable outcome parameters, including an overreliance on full-scale IQ scores or adaptive behavior scales, which do not capture the full range of cognitive skills that may be affected by disease and treatment. 23 , 27 Specifically, full-scale IQ does not cover all essential outcome parameters.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Long-term cognitive deficits in pediatric low-grade glioma (LGG) survivors reflect pretreatment conditions—report from the German LGG studies

Traunwieser

Kandels

Pauls

et al. 2020

Neuro-Oncology Advances

View full text Add to dashboard Cite

Background Disease and treatment contribute to cognitive late-effects following pediatric low-grade glioma (LGG). We analyzed prospectively collected neuropsychological data of German pediatric LGG-survivors and focused on the impact of hydrocephalus at diagnosis, neurofibromatosis type 1 (NF1) status and extent of surgery. Patients and Methods We used the neuropsychological basic diagnostic screening tool based on the Cattell-Horn-Carroll model for intelligence and the concept of cross-battery assessment at 2 and 5 years from diagnosis for 316 patients from the German pediatric LGG-study and LGG-registry (7.1 years median age; 45 NF1; cerebral hemispheres 16%, supratentorial midline 39%, infratentorial 45%). Hydrocephalus was classified radiologically in 137 non-NF1 patients with infratentorial tumors (95/137 complete/subtotal resection). Results Patients with NF1 vs. non-NF1 exhibited inferior verbal short-term memory and visual processing (p<.001-.021). In non-NF1 patients infratentorial tumor-site and complete/subtotal resection were associated with sequelae in visual processing, psychomotor speed and processing speed (p<.001-.008). Non-NF1 patients without surgical tumor reduction and/or non-surgical treatment experienced similar deficits. Degree of hydrocephalus at diagnosis had no further impact. Psychomotor and processing speed were impaired comparably following chemo-/radiotherapy (p<.001-.021). Pre-treatment factors as NF1 or tumor-site were relevant at multivariate analysis. Conclusion All pediatric LGG-survivors are at risk to experience long-term cognitive impairments in various domains. Even surgical only management of cerebellar LGG or no treatment at all, i.e. biopsy only/radiological diagnosis did not protect cognitive function. Since pattern and extent of deficits are crucial to tailor rehabilitation, neuropsychological and quality of survival assessments should be mandatory in future LGG-trials.

show abstract

“…Brain tumors are the most common solid tumors in children, comprising 25% of all childhood cancers [1][2][3]. In this group, pilocytic astrocytomas (PCA) are the second most common, accounting for 21 to 23% of all pediatric brain tumors [3][4][5][6][7]. According to the NeuroSci 2021, 2 96 World Health Organization (WHO), PCA is classified as a Grade I tumor [3,8].…”

Section: Introductionmentioning

confidence: 99%

Cytokines in Pediatric Pilocytic Astrocytomas: A Clinico-Pathological Study

et al. 2021

View full text Add to dashboard Cite

Pilocytic astrocytomas (PCA) are WHO Grade I tumors with a favorable prognosis. Surgical resection is usually curative. Nonetheless, progressive and/or metastatic disease occurs in 20% of patients. For these patients, treatment options are limited. The role of the immune system in PCA has not previously been reported. We hypothesize that the circulating cytokines contribute to tumorigenicity in PCA. This is an exploratory study with a focus on the identification of circulating cerebrospinal (CSF) cytokines associated with PCA. The primary objective is to demonstrate that CSF cytokines will be differentially expressed in the subset of PCAs that are difficult to treat in comparison to their surgically amendable counterparts. This is a single-institution, retrospective study of prospectively collected data. Patients with a confirmed histological diagnosis of PCA who have simultaneous intraoperative CSF sampling are included. Cerebrospinal fluid samples are subjected to multiplex cytokine profiling. Patient-derived PCA lines from selected patients in the same study cohort are cultured. Their cell culture supernatants are collected and interrogated using the sample multiplex platform as the CSF. A total of 8 patients are recruited. There were two patients with surgically difficult tumors associated with leptomeningeal involvement. Multiplex profiling of the cohort’s CSF samples showed elevated expressions of IFN-γ, IL-2, IL-12p70, IL-1β, IL-4, and TNF-α in these two patients in comparison to the remaining cohort. Next, primary cell lines derived from the same PCA patients demonstrated a similar trend of differential cytokine expression in their cell culture supernatant in vitro. Although our findings are preliminary at this stage, this is the first study in pediatric PCAs that show cytokine expression differences between the two groups of PCA with different clinical behaviors.

show abstract

Cerebellar pilocytic astrocytoma in childhood: Investigating the long-term impact of surgery on cognitive performance and functional outcome

Cited by 22 publications

References 26 publications

Clinical characteristics, long-term complications and health-related quality of life (HRQoL) in children and young adults treated for low-grade astrocytoma in the posterior fossa in childhood

Clinical characteristics, long-term complications and health-related quality of life (HRQoL) in children and young adults treated for low-grade astrocytoma in the posterior fossa in childhood

Long-term cognitive deficits in pediatric low-grade glioma (LGG) survivors reflect pretreatment conditions—report from the German LGG studies

Cytokines in Pediatric Pilocytic Astrocytomas: A Clinico-Pathological Study

Contact Info

Product

Resources

About