Artikel
Astrocytomas of the spinal cord in children
Astrozytome des Rückenmarks bei Kindern
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Autoren
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J. Klekamp
- Zentrum für Neurochirurgie, Christliches Krankenhaus Quakenbrück
| Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: This study demonstrates results of treatment for children in comparison to adults to determine, whether differences exist in terms of clinical presentation, surgical results and biological behaviour of these tumors.
Methods: Hospital files, neuroradiological examinations, intraoperative documentations and follow-up examinations were analysed. Outcome was analyzed for changes of neurological symptoms and tumor recurrence rates according to Kaplan-Meier statistics.
Results: Between 1977 and 2007, 65 patients (24 children and 41 adults) were diagnosed with an intramedullary astrocytoma. 60 patients (22 children and 38 adults) underwent surgery. Of these tumors, 83% were benign in children and 73% in adults. There was a trend for a shorter clinical history in children compared to adults (22±32 months and 34±47 months, respectively). Follow-up was similar in both groups (39±41 months and 37±41 months, respectively). At presentation, 83% of children were mainly affected by gait problems and/or motor weakness compared to 64% of adults. Pain in particular tended to be less predominant in children. Children were less likely to undergo a complete resection compared to adults (9% and 21%, respectively) and underwent a subtotal resection in the great majority (74% and 57%, respectively). Postoperatively, 6 children (27%) demonstrated improvements of gait and/or motor power, 10 (45%) were unchanged and 6 (27%) deteriorated. The corresponding figures for adults were 12 (32%), 18 (47%) and 8 (21%) patients. In terms of tumor recurrences, just one recurrence was observed among children after 43 months corresponding to a recurrence rate of 14% after 10 years. For adults, 6 recurrences were observed with a 10-year rate of 29%.
Conclusions: Despite a lower rate of complete resections of intramedullary astrocytomas in children compared to adults, the neurological outcome was similar in both groups with a trend for lower recurrence rates in children. These results indicate a more benign behaviour of astrocytomas in children compared to adults.
