title: Medical, psychological, cognitive and educational late-effects in pediatric low-grade glioma survivors treated with surgery only.
abstract: BACKGROUND
  Surgical resection is often the only treatment necessary for pediatric low-grade gliomas (LGGs) and is thought to define a population with an excellent long-term prognosis. The goal of this study was to describe the multidimensional late-effects of pediatric LGG survivors treated exclusively with surgery.
  
  
  METHODS
  A retrospective chart review of "surgery-only" LGG survivors followed at Dana-Farber/Children's Hospital Cancer Care was undertaken. Patients had to be diagnosed with an LGG before the age of 22 years, treated with "surgery-only" and be at least 2 years from diagnosis.
  
  
  RESULTS
  Sixty survivors were eligible with a median age at the time of review of 16.3 years and the median time since diagnosis of 8.4 years. Tumor locations were predominantly posterior fossa (47%) or cortical (33%). Eighty-five percent of patients had at least one ongoing late-effect, and 28% had three or more. The most common late-effects consisted of motor dysfunction (43%), visual problems (32%), anxiety (19%), social difficulties (19%), seizure disorders (17%), depression (15%), poor coordination/ataxia (14%), behavioral problems (13%), and endocrinopathies (10%). Nine patients had a history of suicidal ideation; two with suicide attempts. The mean full-scale IQ was normal, however, the number of survivors scoring one standard deviation below the mean was twice the expected number. Special education services were utilized by more than half of the survivors.
  
  
  CONCLUSIONS
  "Surgery-only" LGG survivors may be more affected by their tumor and its resection than previously appreciated. A prospective study is needed to address this survivor population.
authors.affiliation: Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA. christopher_turner@dfci.harvard.edu
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Turner
authors.forename: Christine A
authors.initials: CA
authors.lastname: Chordas
authors.forename: Cori C
authors.initials: CC
authors.lastname: Liptak
authors.forename: Celiane
authors.initials: C
authors.lastname: Rey-Casserly
authors.forename: Brian L
authors.initials: BL
authors.lastname: Delaney
authors.forename: Nicole J
authors.initials: NJ
authors.lastname: Ullrich
authors.forename: Liliana C
authors.initials: LC
authors.lastname: Goumnerova
authors.forename: R Michael
authors.initials: RM
authors.lastname: Scott
authors.forename: Heather C
authors.initials: HC
authors.lastname: Begley
authors.forename: William J
authors.initials: WJ
authors.lastname: Fletcher
authors.forename: Xiaopan
authors.initials: X
authors.lastname: Yao
authors.forename: Susan
authors.initials: S
authors.lastname: Chi
authors.forename: Mark W
authors.initials: MW
authors.lastname: Kieran
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D005260:Female; D005910:Glioma / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D006801:Humans; D007360:Intelligence; D008297:Male; D009483:Neuropsychological Tests; D017741:Survivors