Document Detail

In pursuit of prognostic factors in children with pilocytic astrocytomas.
MedLine Citation:
PMID:  19823847     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This study described a 23-year experience in the treatment of children with pilocytic astrocytomas (piloA) with the aim of identifying putative clinical, histopathological, and/or immunohistochemical features that could be related to the outcome of these patients. METHODS: Clinical data of 31 patients under 18 years of age with piloA were obtained from 1984 to 2006. RESULTS: The mean age at the time of surgery was 7.8 +/- 4.2 years (1 to 17 years), and the mean follow-up was 5.7 +/- 5.4 years (1 to 20 years). The most common site of tumor formation was the cerebellum (17), followed by brainstem (4), optic chiasmatic hypothalamic region (4), cerebral hemisphere (3), cervical spinal cord (2), and optic nerve (1). Gross total resection (GTR) was achieved in 23 (74.1%), mainly in those with tumors located in the cerebellum and cerebral hemispheres (P = 0.02). The global mortality rate was 6.4%. Nine patients were reoperated. Rosenthal fibers, eosinophilic granular bodies, microvascular proliferation, and lymphocytic infiltration were observed in most cases. The mean Ki-67LI was 4.4 +/- 4.5%. In all cases, Gal-3 expression in tumor cells was observed with variable staining pattern. CONCLUSIONS: Aside from GTR, no other clinical, histopathological, or immunohistochemical features were found to be related to the prognosis. We postulate that strict follow-up is recommended if piloA is associated with high mitotic activity/Ki67-LI, or if GTR cannot be achieved at surgery. Tumor recurrence or progression of the residual lesion should be strictly observed. In some aspects, childhood piloA remains an enigmatic tumor.
Aline Paix?o Becker; Ricardo Santos de Oliveira; Fabiano Pinto Saggioro; Luciano Neder; Leila Maria Card?o Chimelli; H?lio Rubens Machado
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-10-13
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  26     ISSN:  1433-0350     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-21     Completed Date:  2010-03-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  19-28     Citation Subset:  IM    
Department of Pathology, Ribeir?o Preto School of Medicine, University of S?o Paulo, Ribeir?o Preto, SP, Brazil.
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MeSH Terms
Astrocytoma / diagnosis*,  mortality,  surgery
Brain / pathology,  radiography,  surgery
Brain Neoplasms / diagnosis*,  mortality,  surgery
Child, Preschool
Follow-Up Studies
Galectin 3 / metabolism
Ki-67 Antigen / metabolism
Spinal Cord / pathology,  radiography,  surgery
Spinal Cord Neoplasms / diagnosis*,  mortality,  surgery
Treatment Outcome
Reg. No./Substance:
0/Galectin 3; 0/Ki-67 Antigen

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