Ahead of Print: Resection Improves Pediatric Ganglioglioma Outcome

Background: Gangliogliomas are rare, low-grade, glial-neural tumors most often found in children. They can recur with varying frequency; yet, little data are available that adequately predict such events.

Objective: To review our institution’s large series of gangliogliomas in children and identify clinical features that predict recurrence-free survival.

Methods: Clinical records were retrospectively reviewed from 1990 through 2011. Fifty-three children were identified, and pertinent clinical features were analyzed against survival data to categorize lesions at high risk for recurrence.

Results: Fifteen children (28%) experienced a recurrence during the study period with a median time-to-recurrence of 8.8 months and mean follow-up of 4.2 years. The 5-year recurrence-free survival was 70.5%, while overall survival was 98.1%. Older age at diagnosis (P = .02), seizure history (P < .001), supratentorial tumor location (P < .001), and greater extent of surgical resection (P < .001) were all associated with improved recurrence-free survival in univariate analysis. Extent of surgical resection was the only clinical variable that retained its significance in multivariate models (P = .01). Patients who received a >=94% volumetric extent of resection had prolonged recurrence-free survival compared to those individuals who received a <94% resection (P = .02).

Conclusion: Attention to specific clinical variables, most notably extent of surgical resection, can further stratify grade I gangliogliomas into low- and high-risk groups among children. Although a 100% resection should remain an operative goal for surgically accessible gangliogliomas, a thorough yet subtotal resection may improve recurrence-free survival.

From: Greater Extent of Resection Improves Ganglioglioma Recurrence-free Survival in Children: A Volumetric Analysis by Haydon et al.

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