title: The influence of central review on outcome in malignant gliomas of the spinal cord: the CCG-945 experience.
abstract: OBJECT The impact of central pathology review on outcome has been described in pediatric patients with high-grade glioma (HGG). The objective of this report was to analyze the impact of the central pathology review on outcome in the subgroup of patients with institutional diagnosis of HGG of the spinal cord enrolled in the Children's Cancer Group 945 cooperative study. METHODS Five neuropathologists centrally reviewed the pathology of the 18 patients with HGG of the spinal cord who were enrolled in the study. These reviews were independent, and reviewers were blinded to clinical history and outcomes. A consensus diagnosis was established for each patient, based on the outcome of the review. RESULTS Of 18 patients, only 10 were confirmed to have HGG on central review. At a median follow-up of 12 years, event-free and overall survival for all 18 patients was 43.2% ± 13.3% and 50% ± 13.4%, respectively. After central review, 10-year event-free and overall survival for confirmed HGGs and discordant diagnoses was 30% ± 12.5% versus 58.3% ± 18.8% (p = 0.108) and 30% ± 12.5% versus 75% ± 14.2% (p = 0.0757), respectively. CONCLUSIONS The level of discordant diagnoses in children and adolescents with institutional diagnosis of HGG of the spinal cord was 44% in this experience. However, there was no significant difference in outcome between patients with confirmed and discordant diagnosis. This group of tumor deserves a specific attention in future trials.
authors.affiliation: The Hospital for Sick Children, University of Toronto, Ontario, Canada;
authors.forename: Eric
authors.initials: E
authors.lastname: Bouffet
authors.affiliation: New York University Langone Medical Center, New York, New York;
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Allen
authors.affiliation: Biostatistics, Saint Jude Children's Research Hospital, Memphis, Tennessee;
authors.forename: James M
authors.initials: JM
authors.lastname: Boyett
authors.affiliation: Department of Pathology, The Ohio State University, Columbus, Ohio;
authors.forename: Allen
authors.initials: A
authors.lastname: Yates
authors.affiliation: Department of Pathology, Children's Hospital Los Angeles, California;
authors.forename: Floyd
authors.initials: F
authors.lastname: Gilles
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland;
authors.forename: Peter C
authors.initials: PC
authors.lastname: Burger
authors.affiliation: Department of Pathology, University of California, San Francisco, California;
authors.forename: Richard L
authors.initials: RL
authors.lastname: Davis
authors.affiliation: Department of Pathology, The Hospital for Sick Children, University of Toronto, Ontario, Canada;
authors.forename: Laurence E
authors.initials: LE
authors.lastname: Becker
authors.affiliation: Department of Neurosurgery, Children's Hospital of Pittsburgh, Pennsylvania; and.
authors.forename: Ian F
authors.initials: IF
authors.lastname: Pollack
authors.affiliation: Pediatric Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Finlay
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D060787:Neoplasm Grading; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D016037:Single-Blind Method; D013120:Spinal Cord Neoplasms / Q000175:diagnosis* / Q000628:therapy
keywords: AA = anaplastic astrocytoma; CCG = Children's Cancer Group; EFS = event-free survival; GBM = glioblastoma multiforme; HGG = high-grade glioma; OS = overall survival; central review; malignant glioma; oncology; pathology; spinal cord; spine