NEW YORK (Reuters Health) Aug 12 - Cerebellar tumor location is associated with worse survival in patients with high-grade gliomas (HGG), researchers from Germany report.
Only 5% of all high-grade gliomas (less than 1% of all pediatric brain tumors) arise in the cerebellum, so little is known about pediatric HGG in this site.
Dr. Michael Karremann from Heidelberg University in Mannheim and colleagues compared outcomes for 29 pediatric HGG of the cerebellum with a control group of 180 pediatric patients with non-thalamic supratentorial HGG which had developed in cortical structures.
At least 90% tumor resection was achieved in 72.4% of cerebellar HGG, compared with 59.8% of cortical HGG, a difference that was not statistically significant. Complete remission rates after radiotherapy were similar for cerebellar HGG (41.6%) and cortical HGG (38.5%).
Within the cerebellar HGG group, tumor grade (WHO grade III versus IV or V) was strongly associated with overall and event-free survival, but extent of tumor resection proved irrelevant to survival.
Median overall survival was significantly shorter in patients with cerebellar HGG than in those with cortical HGG (0.92 years vs. 2.03 years, p=0.006), according to the paper, online July 18 in the British Journal of Cancer.
Median event-free survival was non-significantly shorter with cerebellar HGG than with cortical HGG (0.62 year vs. 0.91 year).
Results were similar for the subset of patients with glioblastoma multiforme, where the median overall survival was 1.53 years for cortical and 0.9 year for cerebellar HGG and the median event-free survival was 0.66 year for cortical and 0.53 year for cerebellar HGG.
On Cox-regression analysis, cerebellar tumor location was an independent predictor of poor prognosis (p=0.019).
"Since the tumor site itself was identified as a prognostic parameter and any explanation for the observed clinical differences has probably to go beyond pure differences in neurosurgical accessibility in the different tumor localizations, a varying tumor biology may well explain clinical differences between the investigated tumor sites," the researchers speculate.
"Future molecular analyses shall help to corroborate our observations of the obviously site-specific heterogeneity of pediatric HGG on a molecular genetic basis and further to elucidate the biology of cerebellar HGG in children," they conclude.
Dr. Karremann did not respond to a request for comments.
SOURCE: http://bit.ly/1ctDY1s
Br J Cancer 2013.
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