Adult Brainstem Gliomas: Retrospective Analysis of 51 Patients.
OBJECTIVE
Brainstem gliomas (BSG) constitute less than 2% of brain tumors in adults. Therapeutic options are limited and BSG are associated with a high morbidity and mortality.


METHODS
We reviewed the records of 51 patients with BSG treated at the Institute of Neurosurgery, Clinical Center of Serbia in Belgrade between 1998 and 2012. We recorded demographic and clinical variables as well as radiological findings and survival.


RESULTS
Of the 51 patients, 62.7% were male and 37.3% were female. The mean age was 30.6±19.3 years. High grade glioma (Astrocytoma grade III and IV) was most common at the age of 38.2±17.9 years (t=.481, p=0.017) while low grade glioma (Astrocytoma grade I and II) was common in younger age as 25.4±17.4 years (X2=4.013; p=0.045), with localization in the pons (X2=5.299; p=0.021) and exophytic presentation (X2=3.862; p=0.049). Ataxia, as initial symptom, was a predictor of poor outcome (HR:5.546, p=0.012).


CONCLUSIONS
Due to its specific localization, BSG present a major challenge for neurosurgery, because of the necessity of safe approach for radical resection. Histological verification of BSG determines the need for additional therapeutic procedures such as radiotherapy and chemotherapy. Benefit from correct diagnosis is reflected in the avoidance of potentially adverse effects of treatment.
Clinical Center of Serbia, Clinic for Neurosurgery , Belgrade, Serbia.
Goran
G
Tasic
Nikola
N
Repac
Igor
I
Nikolic
Vojislav
V
Bogosavljevic
Vuk
V
Scepanovic
Aleksandar
A
Janicijevic
Aleksandra
A
Eric-Nikolic
Lukas
L
Rasulic
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001254:Astrocytoma / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D020295:Brain Stem Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000532:radiotherapy / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis / Q000453:epidemiology* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data; D011149:Pons / Q000473:pathology; D012189:Retrospective Studies; D055771:Serbia / Q000453:epidemiology; D055815:Young Adult