Optic pathway glioma: outcome and prognostic factors in a surgical series

Abstract

The preservation rate of ipsilateral vision was 25%, while that of contralateral vision was 83% (P<0.001). There was no remarkable endocrine improvement after surgery. The overall and progression-free survival rates at 5 years were 93.6 and 52.4%, respectively. In our study, the predictors for tumor progression were children younger than 5 years of age (p=0.023) and of female gender (p=0.022). Because of the variable course of OPG, treatment policy should be optimized individually according to patient's status.

Optic pathway gliomas: a review

“…Therefore, contemporary indications for surgery include single nerve involvement causing progressive, disfiguring proptosis, blindness, or both, or exophytic chiasm tumors causing mass effect or hydrocephalus. 2,5,54,55 Surgery is contraindicated in patients with infiltrative tumors. Although authors of numerous case reports have described spontaneous regression of OPG after surgical debulking or biopsy without additional postoperative adjuvant therapy, 25,28,54,55,84,85 it is unclear whether spontaneous regression might have occurred without any treatment at all, which has also been well-reported.…”

“…Although authors of numerous case reports have described spontaneous regression of OPG after surgical debulking or biopsy without additional postoperative adjuvant therapy, 25,28,54,55,84,85 it is unclear whether spontaneous regression might have occurred without any treatment at all, which has also been well-reported. 63,66 In 2006, Ahn et al 2 retrospectively reviewed a series of 33 patients with OPGs who had undergone surgery over a 17-year period. They found that radical removal of OPGs was of no survival benefit and that it did not reduce endocrine complications.…”

“…35,65 In addition, the presence of NF1 and an anterior location are associated with a more favorable prognosis, 23,80 whereas younger age at presentation is associated with a poorer prognosis. 2,29,33,59,74,83 Most patients with OPG have an indolent or even asymptomatic course. Survival for OPGs confined to the optic nerve is close to 100%.…”

“…15,22,30,33 Approximately 75% of these tumors are diagnosed during the first decade of life and 60% are diagnosed before the age of 5 years, which also portends a less favorable prognosis. 2,29,33,74,83 One of the most complete reviews of all cases of OPG was published in 1994 by Dutton,15 who retrospectively reviewed all cases of OPG reported in the literature up to 1992, which included 2297 patients. Of those patients, age data were available for 519 patients, and sex data were given for 594.…”

Opticochiasmatic Apoplexy in a Five-Year-Old

“…Iraci et al [23] reported a series of 5 patients with precocious or pseudoprecocious puberty associated with optic nerve gliomas. Patients with suprasellar tumors have also presented with symptoms of diabetes insipidus [24], syndrome of inappropriate antidiuretic hormone hypersecretion [25], gigantism [26,27], growth hormone deficiency [28], hypothyroidism, adrenal insufficiency, and gonadotropin insufficiency [29]. Ahn et al [29] presented a series of 33 patients who underwent surgery for optic pathway gliomas; 19 had preoperative endocrine abnormalities.…”