title: Pediatric high grade glioma of the spinal cord: results of the HIT-GBM database.
abstract: Little is known about pediatric spinal cord high grade gliomas (SCHGG) beyond their dismal prognosis. Here, we analyzed the HIT-GBM(®) database for the influence of surgical resection on survival. Between 1991 and 2010 the HIT-GBM group collected data from European children diagnosed with high grade glioma. Patients with the following inclusion criteria were analyzed in this study: astrocytic histology, WHO grade III or IV, age at diagnosis <18 years, and tumor localized to the spinal cord. 28 patients (mean age 11.28 years, 14 male) with primary SCHGG were identified. The tumor sizes were measured by the span across adjacent vertebrae and varied greatly (range: 1-20, median: 4). Histology was classified as WHO grade III in 15 and grade IV in 13 tumors. Of note, the four largest tumors identified were WHO grade III. Surgery was classified as complete resection (n = 6), subtotal resection (STR) (n = 7), partial resection (n = 12) or biopsy only (n = 3). 27 patients received chemotherapy, 22 of which also received radiation. With the mean follow-up time of 2.88 (SD ± 2.95) years, 14 patients were still alive resulting in a median overall survival of 2.5 years (SE ± 1.6). The positive prognostic indicators for overall survival were: age younger than 5 years (P = 0.047), WHO grade III (P = 0.046), absence of necrosis (P = 0.025) and gross total resection (GTR) (P = 0.012). The prognosis of SCHGG might not be as miserable as generally assumed. GTR is of benefit. Larger data sets and meta-analysis are necessary to identify patient sub-groups.
authors.affiliation: Baylor College of Medicine, BCM368, One Baylor Plaza, Houston, TX 77030, USA. wolff@bcm.edu
authors.forename: Birte
authors.initials: B
authors.lastname: Wolff
authors.forename: Ann
authors.initials: A
authors.lastname: Ng
authors.forename: Daniela
authors.initials: D
authors.lastname: Roth
authors.forename: Kathleen
authors.initials: K
authors.lastname: Parthey
authors.forename: Monika
authors.initials: M
authors.lastname: Warmuth-Metz
authors.forename: Matthias
authors.initials: M
authors.lastname: Eyrich
authors.forename: Uwe
authors.initials: U
authors.lastname: Kordes
authors.forename: Rolf
authors.initials: R
authors.lastname: Kortmann
authors.forename: Torsten
authors.initials: T
authors.lastname: Pietsch
authors.forename: Christof
authors.initials: C
authors.lastname: Kramm
authors.forename: Johannes Ea
authors.initials: JE
authors.lastname: Wolff
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D009362:Neoplasm Metastasis; D011379:Prognosis; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate