title: Clinical characteristics and late effects in CNS tumours of childhood: Do not forget long term follow-up of the low grade tumours.
abstract: OBJECTIVE
  To investigate clinical characteristics and late effects of CNS tumours in childhood with a special focus on low-grade tumours, especially low-grade astrocytoma and glioneuronal tumours.
  
  
  METHODS
  A retrospective population based study was performed at Uppsala University Children's Hospital, a tertiary referral centre for children with CNS tumours. Patients were identified from the National Brain Tumour Registry and the National Epilepsy Surgery Registry. Hospital medical records were analysed for patients with a follow up of ≥5 years after diagnosis. A re-evaluation of the neuro-pathological diagnosis was performed.
  
  
  RESULTS
  A total of 193 patients (age 0-17.99 years) during a twelve-year period (1995-2006) were included; 149 survived ≥5 years. Three larger subgroups could be identified: astrocytic, embryonal and glioneuronal tumours. A supratentorial location was found in 52%. Medical late effects were mainly neurological and endocrinological, affecting 81% and 26% of surviving patients. Cognitive late effects were a frequent finding in the whole group but also in low-grade astrocytoma and glioneuronal tumours (53% and 67%). Thirty per cent had some kind of pedagogic support in school.
  
  
  CONCLUSIONS
  Late effects are common in long-term survivors of CNS tumours in childhood. Low-grade astrocytoma and glioneuronal tumours are no exception, and the findings support the need for long-term follow up.
authors.affiliation: Department of Women's and Children's Health, Uppsala University and Uppsala University Children's Hospital, Uppsala, Sweden. Electronic address: christoffer.ehrstedt@kbh.uu.se.
authors.forename: Christoffer
authors.initials: C
authors.lastname: Ehrstedt
authors.affiliation: Department of Women's and Children's Health, Uppsala University and Uppsala University Children's Hospital, Uppsala, Sweden.
authors.forename: Ingela
authors.initials: I
authors.lastname: Kristiansen
authors.affiliation: Department of Women's and Children's Health, Uppsala University and Uppsala University Children's Hospital, Uppsala, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Ahlsten
authors.affiliation: Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden; Department of Clinical Pathology and Cytology, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Olivera
authors.initials: O
authors.lastname: Casar-Borota
authors.affiliation: Department of Women's and Children's Health, Uppsala University and Uppsala University Children's Hospital, Uppsala, Sweden.
authors.forename: Margareta
authors.initials: M
authors.lastname: Dahl
authors.affiliation: Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden; Department of Clinical Pathology and Cytology, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Libard
authors.affiliation: Department of Women's and Children's Health, Uppsala University and Uppsala University Children's Hospital, Uppsala, Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Strömberg
mesh_terms: D000293:Adolescent; D001254:Astrocytoma / Q000150:complications / Q000473:pathology* / Q000523:psychology; D016543:Central Nervous System Neoplasms / Q000150:complications / Q000473:pathology* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D018303:Ganglioglioma / Q000150:complications / Q000473:pathology* / Q000523:psychology; D005910:Glioma / Q000150:complications / Q000473:pathology / Q000523:psychology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008527:Medulloblastoma / Q000150:complications / Q000473:pathology* / Q000523:psychology; D060787:Neoplasm Grading; D009373:Neoplasms, Germ Cell and Embryonal / Q000150:complications / Q000473:pathology / Q000523:psychology; D012042:Registries; D012189:Retrospective Studies; D017741:Survivors; D013995:Time
keywords: CNS-tumour; Childhood; Cognitive; Late effects; Low grade