title: [Prognosis of clinical course of primary brain tumours in children in relationship to the duration and characteristic features of initial clinical symptoms].
abstract: Primary tumours of the central nervous system belong to the most frequently occurring neoplastic diseases in paediatric patients. During the initial phase of disease development, the clinical symptoms of brain tumours might suggest disorders of other organs and their diagnosis is frequently delayed in relation to therapeutic possibilities. The aim of the study was to analyse the characteristic features and duration of preliminary symptoms arising due to brain tumours in paediatric patients treated in a single centre and to try to assess their prognostic significance for recurrence and death.
  
  
  METHODS
  We performed a retrospective assessment of the characteristic features of preliminary symptoms of brain tumours in 81 paediatric patients (45 female, 35 male) in the age range of 1.5 month - 17.2 years. Those characteristic features included the duration of symptoms until diagnosis (Pre-Diagnostic Symptoms Interval, PSI) and their correlation with the tumour type, its localization and size at the moment of diagnosis.
  
  
  RESULTS
  The mean duration of symptoms in the studied group was 3 months. In nearly 45% of patients PSI was longer then 3 months and in 17,5% it was over 6 months. The predominant preliminary disease symptoms were the symptoms of increased intracranial pressure (n=56, 69,1%) The longer PSI correlated with the disease recurrence rate (p=0.024) and death rate (p=0.04). When PSI was longer then 6 months, all the tumours diagnosed were larger then 30 mnm, however no relationship was found between PSI duration and the tumor size (p=0.35). There was no correlation between the tumour size and the frequency of death (p=0.8), but in patients with tumours smaller then 30 mm in their greatest dimension, the recurrence of the neoplastic process was more frequent.
  
  
  CONCLUSIONS
  Duration of preliminary symptoms may have an effect on the tumour recurrence and on the rate of death in paediatric patients with brain tumours. Early diagnosis plays an evident role in prognosis.
authors.affiliation: Katedra i Klinika Chorób Dzieci Uniwersytetu Medycznego w Lodzi. bszewczyk@alef.umed.lodz.pl
authors.forename: Beata
authors.initials: B
authors.lastname: Zalewska-Szewczyk
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Zielińska
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Zakrzewski
authors.forename: Monika
authors.initials: M
authors.lastname: Bulas
authors.forename: Witalij
authors.initials: W
authors.lastname: Andrzejewski
authors.forename: Jerzy
authors.initials: J
authors.lastname: Bodalski
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000628:therapy; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009367:Neoplasm Staging; D010808:Physical Examination / Q000379:methods*; D011044:Poland; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors