Long-term follow-up of pediatric benign cerebellar astrocytomas

Hideki Ogiwara, Robin M. Bowman, Tadanori Tomita*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

BACKGROUND: The long-termprognosis of cerebellar astrocytomas needs to be reviewed. OBJECTIVE: To elucidate the factors influencing tumor recurrence or progression and to determine how long these patient with cerebellar astrocytomas require surveillance with neuroimaging. METHODS: A retrospective review of 101 children surgically treated for a cerebellar astrocytoma and followed up for > 10 years was performed. RESULTS: Mean follow-up was 18.4 years. Total resection confirmed by postoperative imaging was performed in 51 patients (50.5%; group A). Twenty-three patients (22.8%) had surgical total resection; however, equivocal residual tumor was found on postoperative imaging (group B). Subtotal resection leaving a portion of brainstem or cerebellar peduncle was performed in 27 patients (26.7; group C). Of these 50 residual tumors, 16 (32%) showed spontaneous regression and 8 (16%) showed arrested growth. Radiographic recurrence or progression was noted in 29 patients (28.7%). Only 3 of 51 patients (5.9%) of group A with total resection had recurrence, whereas 26 of 50 residual tumors (52%; groups B and C) progressed. The only factor affecting recurrence or progression by multivariate analysis was the extent of surgical resection. All tumor recurrence or progression except for 1 (96.6%) occurred within 8 years from the original surgery (range, 2-132 months). CONCLUSIONS: Overall prognosis of cerebellar astrocytomas is good; the 10-year survival rate was 100% and recurrence-or progression-free rate was 71.3% in our cohort. Almost half of residual tumors showed spontaneous regression or arrested growth in the long term. Eight to 10 years is considered to be a reasonable follow-up period by neuroimaging.

Original languageEnglish (US)
Pages (from-to)40-47
Number of pages8
JournalNeurosurgery
Volume70
Issue number1
DOIs
StatePublished - Jan 2012

Keywords

  • Astrocytoma
  • Cerebellum
  • Prognostic factors
  • Recurrence
  • Spontaneous regression

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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