title: Low-grade gliomas in children: single institutional experience in 198 cases.
abstract: BACKGROUND
  In pediatric population (0-18 years), low-grade gliomas (PLGG) are the most frequent brain tumors and majority are amenable for surgical removal.
  
  
  METHODS
  A retrospective review of 198 children diagnosed with PLGG between 1980 and 2010 at HSJD was carried out. Several variables were studied to find prognostic factors related to the outcomes (progression-free survival (PFS) and overall survival (OS)).
  
  
  RESULTS
  Median age at onset was 88.8 months (3.1 to 214.5 months, SD 53). Surgery was performed in 175 patients (88.4%), achieving gross total resection (GTR) in 77 (44%), subtotal resection (STR) in 87 (49.7%), and 11 (6.3%) biopsies. Pathological review classified 84 tumors as WHO grade I (48%) and 89 as grade II (50.8%). Adjuvant therapy (AT) was given to 75 patients (37.9%), radiotherapy in 24 (12.1%), chemotherapy in 33 (16.7%), and combined in 18 (9.1%). Sixteen patients (8.1%) died, 89 (43.4%) are alive with no evidence of disease, and 93 (47%) alive with disease, median follow-up 65.2 months. Outcome is significantly correlated with age (p = 0001, worse OS for patients younger than 12 months) and extent of tumor resection (p < 0001). OS for GTR/STR/biopsy was >200, 154.3, and 101.9 months, respectively. Patients treated with AT presented worse OS/PFS (p < 0.001) than those not treated. Histology was non significantly related to outcomes.
  
  
  CONCLUSIONS
  In our series of PLGG, the best prognostic markers are tumor location (cerebellar) and the extent of tumor resection (GTR). Infants and patients who require adjuvant therapy because of tumor progression or recurrence have worse outcome.
authors.affiliation: Department of Neurosurgery, Hospital Sant Joan de Déu, University of Barcelona, Passeig St. Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain, dendrita07@gmail.com.
authors.forename: Magda
authors.initials: M
authors.lastname: Garzón
authors.forename: Gemma
authors.initials: G
authors.lastname: García-Fructuoso
authors.forename: Mariona
authors.initials: M
authors.lastname: Suñol
authors.forename: Jaume
authors.initials: J
authors.lastname: Mora
authors.forename: Ofelia
authors.initials: O
authors.lastname: Cruz
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005910:Glioma / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D016016:Proportional Hazards Models; D018709:Statistics, Nonparametric
chemical_list: D000970:Antineoplastic Agents