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Neuropathological and neuroradiological spectrum of pediatric malignant gliomas: correlation with outcome.
- Source :
-
Neurosurgery [Neurosurgery] 2011 Jul; Vol. 69 (1), pp. 215-24. - Publication Year :
- 2011
-
Abstract
- Background: The diagnostic accuracy and reproducibility for glioma histological diagnosis are suboptimal.<br />Objective: To characterize radiological and histological features in pediatric malignant gliomas and to determine whether they had an impact on survival.<br />Methods: We retrospectively reviewed a series of 96 pediatric malignant gliomas. All histological samples were blindly and independently reviewed and classified according to World Health Organization 2007 and Sainte-Anne classifications. Radiological features were reviewed independently. Statistical analyses were performed to investigate the relationship between clinical, radiological, and histological features and survival.<br />Results: Cohort median age was 7.8 years; median follow-up was 4.8 years. Tumors involved cerebral hemispheres or basal ganglia in 82% of cases and brainstem in the remaining 18%. After histopathological review, low-grade gliomas and nonglial tumors were excluded (n = 27). The World Health Organization classification was not able to demonstrate differences between groups and patients survival. The Sainte-Anne classification identified a 3-year survival rate difference between the histological subgroups (oligodendroglioma A, oligodendroglioma B, malignant glioneuronal tumors, and glioblastomas; P = .02). The malignant glioneuronal tumor was the only glioma subtype with specific radiological features. Tumor location was significantly associated with 3-year survival rate (P = .005). Meningeal attachment was the only radiological criteria associated with longer survival (P = .02).<br />Conclusion: The Sainte-Anne classification was better able to distinguish pediatric malignant gliomas in terms of survival compared with the World Health Organization classification. In this series, neither of these 2 histological classifications provided a prognostic stratification of the patients.
- Subjects :
- Adolescent
Brain metabolism
Brain Neoplasms mortality
Brain Neoplasms surgery
Child
Child, Preschool
Chromosomal Proteins, Non-Histone metabolism
DNA-Binding Proteins metabolism
Female
Glioma mortality
Glioma surgery
Humans
Infant
Infant, Newborn
Ki-67 Antigen metabolism
Longitudinal Studies
Magnetic Resonance Imaging methods
Male
Nerve Tissue Proteins metabolism
Radiography
Regression Analysis
Reproducibility of Results
Retrospective Studies
SMARCB1 Protein
Survival Analysis
Transcription Factors metabolism
Brain diagnostic imaging
Brain pathology
Brain Neoplasms diagnosis
Glioma diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4040
- Volume :
- 69
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 21368704
- Full Text :
- https://doi.org/10.1227/NEU.0b013e3182134340