title: Improved survival after gross total resection of malignant gliomas in pediatric patients from the HIT-GBM studies.
abstract: The present study was performed to investigate the prognostic impact of tumor resection on survival in children and adolescents with malignant gliomas. From the HIT-GBM data base of the Gesellschaft für Paediatrische Onkologie und Haematologie (GPOH), 85 pediatric patients with malignant non-pontine gliomas were analyzed. Histological diagnosis and extent of tumor resection had been confirmed by central neuropathological review and post-surgical imaging. The extent of tumor resection represented the most prominent prognostic factor for overall (OS) and event-free survival (EFS) in univariate and Cox regression analyses. Four-year survival after gross total tumor resection was 48.0 +/- 12.0% (OS) and 14.1 +/- 8.9% (EFS), after non-total resection 13.2 +/- 6.1% and 2.9 +/- 2.8%, respectively. From several clinical parameters, only histological grading displayed a similar statistical significance in Cox regression analysis. In conclusion, gross total tumor resection improves survival in pediatric patients with malignant gliomas and should always be attempted when possible.
authors.affiliation: Department of Pediatric Oncology, Hematology & Immunology, University Children's Hospital, Duesseldorf, Germany.
authors.forename: Christof M
authors.initials: CM
authors.lastname: Kramm
authors.forename: Sabine
authors.initials: S
authors.lastname: Wagner
authors.forename: Stefan
authors.initials: S
authors.lastname: Van Gool
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Schmid
authors.forename: Ronald
authors.initials: R
authors.lastname: Sträter
authors.forename: Astrid
authors.initials: A
authors.lastname: Gnekow
authors.forename: Stefan
authors.initials: S
authors.lastname: Rutkowski
authors.forename: Johannes E A
authors.initials: JE
authors.lastname: Wolff
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005910:Glioma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016019:Survival Analysis