Clinical, radiologic and pathologic features and outcome following surgery for cervicomedullary gliomas in children

Maio, Salvatore Di; Gul, Shahid; Cochrane, D. Douglas; Hendson, Glenda; Sargent, Michael A.; Steinbok, Paul

doi:10.1007/s00381-009-0956-x

Cited by 14 publications

(9 citation statements)

References 13 publications

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“…An MRI is mandatory to reveal the tumor. Evaluation of tumor size and relation to other structures remain primary imaging endpoints in the evaluation for most pediatric patients with central nervous system (CNS) neoplasms [ 9 ], [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Triad of torticollis, photophobia and epiphora in a child with a posterior fossa tumor

Buijsrogge

Dauwe

Delbeke

2014

GMS Ophthalmology Cases; 4:Doc08; ISSN 2193-1496

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Section: Discussionmentioning

confidence: 99%

Triad of torticollis, photophobia and epiphora in a child with a posterior fossa tumor

Buijsrogge

Dauwe

Delbeke

2014

GMS Ophthalmology Cases; 4:Doc08; ISSN 2193-1496

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“…4,16,24,38,40 Patients with longer prodrome and less severe neurological deficits prior to resection typically have the lowest risk of sustaining a significant neurological deficit after surgery, and in general have a favorable overall survival prognosis. 1,14,33,38 However, depending on the tumor pathological and radiographic characteristics, radiotherapy (RT) and/or chemotherapy may supplement or be considered a better primary treatment than surgery. 2 Surgery, in such cases, would be reserved for tissue diagnosis only.…”

Section: 2332mentioning

confidence: 99%

Cervicomedullary tumors in children

McAbee

Modica

Thompson

et al. 2015

PED

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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.

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“…Factors most commonly associated with poor survival are a short duration of symptoms prior to diagnosis, encasement of the basilar artery on MR imaging, and abducens nerve palsy at presentation (Fisher et al 2000). astrocytomas, gangliogliomas and WHO grade II astrocytomas (Young Poussaint et al 1999;Di Maio et al 2009). Adults also tend to have a better prognosis with a median survival of 59-83 months and overall survival at 5 and 10 years of 58% and 41%, respectively (Kesari et al 2008;Salmaggi et al 2008).…”

Section: Prognosismentioning

confidence: 99%

“…However, surgical morbidity may be significant (Di Maio et al 2009). However, surgical morbidity may be significant (Di Maio et al 2009).…”

Section: Treatmentmentioning

confidence: 99%

“…Successful surgery has been related to a longer duration of symptoms and low-grade pathology (Young Poussaint et al 1999). Patients with subtotal or partial resection may be treated adjuvantly with chemotherapy or radiotherapy and a second surgery may be possible (Di Maio et al 2009). Di Maio and colleagues (2009) found that patients who had interposed nonenhancing tissue contiguous with normal cervical cord or medulla on MRI and abnormal hypointensity on T1-weighted imaging beyond the obvious tumor had a poorly defined tumor/brainstem interface with increased risk of surgical morbidity.…”

Section: Treatmentmentioning

confidence: 99%

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