Chen Zirong, Guo Zhongyin, Wang Junhong, Cao Dan, Xu Yu, Dong Fangyong, Wan Feng
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University Science and Technology, Wuhan, 430030, China.
Department of Neurosurgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
Childs Nerv Syst. 2023 Mar;39(3):593-601. doi: 10.1007/s00381-023-05841-3. Epub 2023 Jan 20.
Pediatric gliomas are the most common central nervous system (CNS) tumors in children and adolescents and show different clinical and histopathological characteristics from the adult. The prognostic factors were poorly defined in pediatric intracranial gliomas.
We collected pediatric intracranial glioma cases in our institution between February 2011 and June 2022. The patient clinical data, tumor growth characteristics, treatments, and follow-up data were analyzed by Cox regression analysis to identify impact factors on the prognosis of pediatric intracranial glioma patients. To corroborate our data, an independent cohort of pediatric intracranial glioma from the Surveillance, Epidemiology, and End Results Program (SEER) database was analyzed.
A total of 181 cases of pediatric low-grade glioma (PLGG) and 45 cases of pediatric high-grade glioma (PHGG) were included. In multivariate Cox regression analysis, tumor size > 59.5 mm (p = 0.006) and non-gross total resection (non-GTR; subtotal resection, STR, p = 0.042; biopsy, p = 0.012) were associated with decreased overall survival (OS) in PLGG patients. In PHGG patients, only chemotherapy (p = 0.023) was associated with OS while tumor size was marginally prognostic for OS (p = 0.051). Additional independent analysis of 2734 PLGG and 741 PHGG from the SEER database corroborated that larger tumor size was associated with decreased OS in LGG (p = 0.001) and HGG (p < 0.001) patients, separately.
In this study, we found that tumor size was a significant prognostic factor for the OS of PLGG patients in our series. Besides the tumor size, the extent of resection also independently impacted the prognosis of PLGG patients. While in PHGG patients, only chemotherapy was associated with improved OS and tumor size was marginally prognostic.
小儿胶质瘤是儿童和青少年中最常见的中枢神经系统（CNS）肿瘤，其临床和组织病理学特征与成人不同。小儿颅内胶质瘤的预后因素尚不明确。
我们收集了2011年2月至2022年6月期间本机构的小儿颅内胶质瘤病例。通过Cox回归分析对患者的临床数据、肿瘤生长特征、治疗方法及随访数据进行分析，以确定影响小儿颅内胶质瘤患者预后的因素。为了验证我们的数据，对来自监测、流行病学和最终结果计划（SEER）数据库的一组独立的小儿颅内胶质瘤病例进行了分析。
共纳入181例小儿低级别胶质瘤（PLGG）和45例小儿高级别胶质瘤（PHGG）。在多变量Cox回归分析中，肿瘤大小>59.5 mm（p = 0.006）和非全切除（非GTR；次全切除，STR，p = 0.042；活检，p = 0.012）与PLGG患者总生存期（OS）降低相关。在PHGG患者中，只有化疗（p = 0.023）与OS相关，而肿瘤大小对OS的预后影响微弱（p = 0.051）。对SEER数据库中另外2734例PLGG和741例PHGG进行的独立分析证实，较大的肿瘤大小分别与LGG（p = 0.001）和HGG（p < 0.001）患者的OS降低相关。
在本研究中，我们发现肿瘤大小是我们系列研究中PLGG患者OS的一个重要预后因素。除肿瘤大小外，切除范围也独立影响PLGG患者的预后。而在PHGG患者中，只有化疗与OS改善相关，肿瘤大小对预后影响微弱。
