Turkish Neurosurgery
is The knowledge pertained to adult glioblastomas enough for pediatric cases? Prognostic factors in childhood
Burçak Bilginer1, Şahin Hanalioğlu1, Cezmi Çağrı Türk2, Fırat Narin3, Kader Karlı Oğuz4, Figen Söylemezoğlu5, Nejat Akalan1
1Hacettepe University, School of Medicine, Neurosurgery, Ankara,
2Ministry of Health, Antalya Education and Research Hospital, Neurosurgery, Antalya,
3Hacettepe University, Institute of Neurological Sciences and Psychiatry, Neurosurgery, Ankara,
4Hacettepe University, School of Medicine, Radiology, Ankara,
5Hacettepe University, School of Medicine, Pathology, Ankara,
DOI: 10.5137/1019-5149.JTN.15780-15.1
Aim:Pediatric glioblastoma is still a topic obscurities. This study was to explore clinical, radiological and pathological features, and prognostic factors affecting the outcomes.Material and Methods:We retrospectively reviewed our database for prognostic factors for 42 consecutive pediatric patients with histologically proven GBM treated in our hospital. Results:The study reached at 20 boys and 22 girls, with a mean age of 10.2 years. Almost all patients (97.6%) had supratentorial tumors; lobar/hemispheric (68.3%), thalamic (26.8%) and suprasellar-hypothalamic region (4.8%). Total of 11/42 children had seeding metastases (mean 11.5 months) either preoperatively or postoperatively. Gross total resection (GTR) was achieved in 13 patients (30.9%) in the first surgery. Perioperative mortality and morbidity rates were 4.7% and 19%, respectively. Patients were followed for an average of 18.1 months. The median progression-free and overall survivals were 7.0 (95% CI: 5.9-8.0) and 11.0 (95% CI: 8.9-13.1) months, respectively. 1-year, 2-year and 5-year progression-free survival and overall survivals were 30.9% vs. 50.0%, 11.9% vs. 19.0%, 4.8% vs. 9.5%; respectively. Conclusion:Gross total resection should be safely attempted in pediatric GBM. In addition, a thorough and frequent radiological evaluation of the entire neuraxis for seeding metastases is recommended both at diagnosis and follow-ups.
Corresponding author : Burçak Bilginer