Pilocytic astrocytomas in children: Prognostic factors - A retrospective study of 80 cases
Pilocytic astrocytomas in children: Prognostic factors - A retrospective study of 80 cases
复制标题
DOI：
10.1227/01.neu.0000079330.01541.6e
复制
发表时间：
2003-09-01
期刊：
影响因子：
4.8
通讯作者：
Lena, G
中科院分区：
文献类型：
--
作者：
Fernandez, C;Figarella-Branger, D;Lena, G
目的：毛细胞型星形细胞瘤（PA）是一种预后良好的I级脑肿瘤。但在某些情况下，患者的结局并不好。我们研究的目的是寻找潜在的临床病理因素与患者的预后与这种diseases.METHODS：我们回顾了临床，神经放射学，和组织病理学特征的80个PA，（小脑33例，视交叉18例，脑干16例，脊髓7例，丘脑3例，视神经2例，半球1例）。病理检查发现58例典型的PA和20例毛粘液样星形细胞瘤，这是PAS的组织学变异。两个案件仍未分类。平均总随访时间为58个月，5年无进展生存率为75%，全切除和部分切除后的5年生存率分别为100%和92%。单因素分析显示部分切除、视交叉PA定位和毛粘液样变异与预后差相关，但后两者与切除程度密切相关，在多因素分析中不能作为独立的预后因素。在接受部分手术切除的患者中，只有周围结构的侵犯与预后有关。结论：PA是良性肿瘤，但一些临床病理因素，如部分切除，视交叉的位置，周围结构的侵犯，和毛粘液样变异，预后较差。
OBJECTIVE: Pilocytic astrocytomas (PA) are Grade I brain tumors characterized by an excellent prognosis. In some cases, however, the patient has a bad outcome. The aim of our study was to search for the clinicopathological factors underlying the prognosis for patients with this disease.METHODS: We reviewed the clinical, neuroradiological, and histopathological features of 80 PAs, (33 cerebellar, 18 optochiasmatic, 16 brainstem, 7 spinal cord, 3 thalamic, 2 optic nerve, and 1 hemispheric) in pediatric patients.RESULTS: Pathological examination revealed 58 classic PAs and 20 pilomyxoid astrocytomas, which are a histological variant of PAS. Two cases remained unclassified. The mean overall follow-up period was 58 months, the 5-year progression-free survival rate was 75%, and the 5-year survival rates were 100 and 92% after total and partial removal. Univariate statistical analysis revealed that partial resection, optochiasmatic PA localization, and pilomyxoid variant were associated with a worse prognosis, but the latter two were too closely related to the extent of resection to be independent prognostic factors in multivariate analysis. Among the patients who underwent partial surgical removal, only invasion of the surrounding structures was related to prognosis.CONCLUSION: PAs are benign tumors, but some clinicopathological factors, such as partial resection, optochiasmatic location, invasion of surrounding structures, and the pilomyxoid variant, have a worse prognosis.