A systematic review of neuropsychological outcomes following posterior fossa tumor surgery in children.
OBJECTIVE
Central nervous system tumors are the most common solid tumors in the pediatric population. As children with central nervous system (CNS) tumors are surviving into adolescence and adulthood, more research is being focused on the long-term cognitive outcomes of the survivors. This review examines the literature on different cognitive outcomes of survivors of different childhood posterior fossa CNS tumor types.


METHODS
The authors reviewed the literature for articles published from 2000 to 2012 about long-term neuropsychological outcomes of children diagnosed with posterior fossa brain tumors before the age of 18, which distinguished between histological tumor types, and had a minimum follow-up of 3 years.


RESULTS
The literature search returned 13 articles, and a descriptive analysis was performed comparing intelligence quotient (IQ), attention/executive function, and memory components of 456 survivors of childhood posterior fossa tumors. Four articles directly compared astrocytoma and medulloblastoma survivors and showed medulloblastoma survivors fared worse in IQ, attention/executive function, and memory measurements. Five articles reporting medulloblastomas found IQ, attention, and memory scores to be significantly below the standardized means. Articles examining astrocytoma survivors found IQ scores within the normal range for the population. Survivors of ependymomas reported 2/23 survivors impaired on IQ scores, while a second study reported a significant number of ependymoma survivors lower than the expected population norm.


CONCLUSIONS
Tumor histopathology and the type of postoperative adjuvant therapy seem to have a significant impact on the long-term neuropsychological complications of pediatric posterior fossa CNS tumor survivors. Age at diagnosis and treatment factors are important variables that affect the outcomes of the survivors.
Saint Louis University School of Medicine, Saint Louis, MO, USA.
Emily
E
Hanzlik
Department of Psychology, SSM Cardinal Glennon Children's Medical Center, Saint Louis, MO, USA.
Stacey E
SE
Woodrome
Division of Hematology/Oncology, Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO, USA.
Mohamed
M
Abdel-Baki
Division of Child Neurology, Department of Neurology and Psychiatry, Saint Louis University School of Medicine, Saint Louis, MO, USA.
Thomas J
TJ
Geller
Division of Pediatric Neurosurgery, Department of Neurological Surgery, Saint Louis University School of Medicine, 1465 South Grand Blvd, Suite 2705, Saint Louis, MO, 63104, USA. selbabaa@slu.edu.
Samer K
SK
Elbabaa
D002648:Child; D003072:Cognition Disorders / Q000209:etiology*; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D006801:Humans; D015192:Infratentorial Neoplasms / Q000601:surgery; D008607:Intellectual Disability / Q000209:etiology*; D007361:Intelligence Tests; D009483:Neuropsychological Tests; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology*
Brain tumors; Long-term sequelae; Neuropsychological outcomes; Pediatrics; Posterior fossa tumors