Prognostic limitations of the Daumas-Duport grading scheme in childhood supratentorial astroglial tumors.
The Daumas-Duport grading scheme (DDGS) is a commonly used method for determining the grade of a tumor. It scores 4 histologic features and is used as a prognostic tool in adult astroglial tumors. This system of assigning children to prognostically homogeneous groups has not been evaluated. The Childhood Brain Tumor Consortium (CBTC) database includes 327 children with a CBTC assigned World Health Organization (WHO) diagnosis of supratentorial astroglial tumor and histologic features necessary for Daumas-Duport grading. We compared survival estimates for tumors within and between DDGS grades using a slightly broadened definition of endothelial prominence. The DDGS yielded only 3 histologic groups in children and only 2 prognostically differing groups. Subgroups within DDGS grades had significantly different survival distributions. The summing of 4 disparate histologic features in the DDGS is inadequate for the assessment of childhood supratentorial astroglial tumors. A classification system more fully summarizing the complete histologic content of tumors is most likely to provide diagnoses useful for clinical purposes.
Brown
W D
WD
Department of Pediatrics, Rhode Island Hospital, Providence 02903, USA.
Gilles
F H
FH
Tavaré
C J
CJ
Rorke
L B
LB
Davis
R L
RL
Adelman
L
L
Hedley-Whyte
E T
ET
Leviton
A
A
D000293:Adolescent; D000328:Adult; D001254:Astrocytoma / Q000473:pathology*; D002528:Cerebellar Neoplasms / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D004727:Endothelium / Q000473:pathology; D005909:Glioblastoma / Q000473:pathology*; D006801:Humans; D008938:Mitosis / Q000502:physiology; D009336:Necrosis; D011379:Prognosis; D016019:Survival Analysis