Outcome of children with low-grade cerebellar astrocytoma: long-term complications and quality of life.
OBJECTIVE
To study the long-term outcome of surgically treated low-grade cerebellar astrocytomas in children.


METHODS
We followed 31 consecutive patients under 16 years of age who were diagnosed between 1980 and 2005 in a single institution. In 21 of 31 survivors (median follow-up time 7.9 years; range 5.6-27.4 years) who agreed to participate, tumor control, neurological and cognitive complications, and their impact on behavioral and emotional adjustment and health-related quality of life (HRQoL) were comprehensively assessed qualitatively and quantitatively.


RESULTS
Neurological sequelae were found in 43%. However, age-appropriate ability to perform daily life activities was normal in all patients. Remarkably, cognitive deficits leading to significant school problems occurred in 19% and behavioral and emotional adjustment disturbances in 27%. In comparison with healthy controls, the survivors rated their HRQoL similarly or even higher.


CONCLUSIONS
Childhood low-grade cerebellar astrocytomas have an excellent cure rate by tumor surgery alone. When compared with other pediatric brain tumors, the risk of neurological, cognitive, emotional, and behavioral complications is relatively small. HRQoL is similar to that of healthy controls.
Zuzak
Tycho J
TJ
Division of Oncology, University Children's Hospital of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
Poretti
Andrea
A
Drexel
Barbara
B
Zehnder
Daniel
D
Boltshauser
Eugen
E
Grotzer
Michael A
MA
D000203:Activities of Daily Living; D001254:Astrocytoma / Q000473:pathology / Q000601:surgery*; D002528:Cerebellar Neoplasms / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D011788:Quality of Life; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome