Turkish Neurosurgery
Clinical features, treatment, and outcome of childhood glial tumors
Buket Kara1, Kübra Ertan2, Pınar Karabağlı3, Hakan Karabağlı4, Güler Yavaş5, Ahmet Okay Çağlayan6, Yavuz Köksal1
1Selcuk University, Faculty of Medicine, Department of Pediatric Hematology and Oncology, Konya,
2Selcuk University, Faculty of Medicine, Department of Pediatrics, Konya,
3Selcuk University, Faculty of Medicine, Department of Pathology, Konya,
4Selcuk Univeristy, Faculty of Medicine , Department of Neurosurgery, Konya,
5Selcuk University, Faculty of Medicine, Department of Radiation Oncology, Konya,
6Dokuz Eylul University, , Department of Medical Genetics, Konya,
DOI: 10.5137/1019-5149.JTN.34801-21.2
Aim: This study aimed to evaluate the clinical features, treatment approaches, and outcomes of glial tumors in children. Material and Methods:Files (2006 to 2020) of children diagnosed with glial tumors and followed-up were reviewed retrospectively. Information regarding demographic and clinical characteristics, treatment approaches, and outcomes were retrieved from the patients\' files.Results:Of the total of 180 pediatric patients diagnosed with brain tumors, 73 (40.6%) had glial tumors. The children with astrocytoma were in the age range of 2–18 years (median age: 8.7 years), while the ages of children with ependymoma ranged from three months to 10 years (median age: 3 years). This difference was statistically significant (p < 0.0001). The male to female ratio was 1.6. The most common symptoms or signs were headaches (n = 34, 46.6%), abnormal gait or coordination (n = 22, 30.2%), vomiting (n = 21, 28.8%), and cranial nerve palsies (n = 20, 27.4%). The pathological diagnoses were astrocytomas (n = 53, 72.6%), oligodendroglial tumors (n = 2, 2.7%), ependymoma (n = 15, 20.7%), and other glial tumors (n = 3, 4.1%). The most common tumor location was supratentorial (n = 42, 57.5%), while midline glioma was detected in seven patients. The 5-year overall survival (OS) rate of all glial tumors, astrocytoma, and ependymoma was 42%, 40%, and 55%, respectively. The 5-year OS rate of the tumor Grade I, II, III, and IV was 77.2%, 45%, 32%, and 0%, respectively (p < 0.0001). The 5-year OS rate of supratentorial, infratentorial, and spinal tumors was 25.6%, 63.6%, and 50%, respectively (p = 0.021). In Cox regression analysis, it was found that the tumor resection and grade had an effect on the tumor prognosis.Conclusion:Treatment results are not satisfactory in high-grade astrocytomas. There is a need for new treatment approaches that would take cognizance of molecular features and adopt multidisciplinary approaches.
Corresponding author : Yavuz Köksal