ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2024
Cerebellar pilocytic astrocytoma: predictors of recurrence based on MRI morphology-a single-centre experience.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- Neuro-ophthalmological disturbances in pediatric posterior fossa tumors: Prevalence, risk factors, and outcomes.Neuro-oncology advancesArticle
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Abstract
purposeWe aimed to present our surgical experience and the impact of a solid or cystic morphology of cerebellar pilocytic astrocytoma (cPA) on surgery and the risk for a re-resection.
methodsWe retrospectively analyzed all children operated at our institution between 2009 and 2023 for cPA. Tumours were categorized into 4 groups: (i) cystic PA without cyst wall enhancement, (ii) cystic PA with cyst wall enhancement, (iii) solid tumour, (iv) and solid tumour with central necrosis.
resultsForty-two children with a median age at surgery of 7.1 years (range 0.7-14 years; male to female ratio 1.5) were identified. The median follow-up time was 3.1 years (0.6-14 years). Twenty-eight patients (66.6%) presented with cystic PA (20 without and 8 with cyst wall enhancement), 9 patients (21.4%) exhibited a solid tumour with central necrosis and 5 (11.9%) had a solid tumour without central necrosis. Gross total resection could be achieved in 31 patients (73.8%), near total resection in 6 (14.3%), and subtotal resection in 5 (11.9%). Progression occurred in 11 cases with 9 patients having a 2nd resection after a mean time of 3.4 years. The highest risk for a 2nd resection was seen in the group of solid tumours with a necrotic centre (odds ratio = 2.3), progression of enhancing cyst wall remnants was seen in one out of two patients with remnants needing reoperation.
conclusionSurgery in cerebellar PA should aim for gross total resection of the solid-enhancing tumour.
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