Thalamic tumors in children : a reappraisal
Identifieur interne : 009318 ( Main/Exploration ); précédent : 009317; suivant : 009319Thalamic tumors in children : a reappraisal
Auteurs : Stephanie Puget [France] ; Darach W. Crimmins [Royaume-Uni] ; Matthew R. Garnett [France] ; Jacques Grill [France] ; Ricardo Oliveira [France] ; Nathalie Boddaert [France] ; Alison Wray [Australie] ; Arielle Lelouch-Tubiana [France] ; Thomas Roujeau [France] ; Federico Di Rocco [France] ; Michel Zerah [France] ; Christian Sainte-Rose [France]Source :
- Journal of neurosurgery. Pediatrics
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English descriptors
Abstract
Object Two to five percent of pediatric brain tumors are located in the thalamus. The optimal management for these tumors remains unclear. The aim of this study was to determine whether clinical and neuroimaging features could guide treatment, and to what extent these features, together with histological diagnosis and treatment modalities, influenced survival. Methods. The records of 69 children who presented with a thalamic tumor between 1989 and 2003 were retrospectively reviewed. Three groups of tumors were analyzed separately: 1) unilateral thalamic tumors (54 lesions): 2) thalamopeduncular tumors (six); and 3) bilateral thalamic tumors (nine). In the patients in whom a unilateral thalamic tumor was diagnosed, 33 had an astrocytic tumor. Of the 54 patients, 32 had a low-grade and 22 had a high-grade tumor. The survival rate was significantly better for patients with the following characteristics: symptom duration longer than 2 months (p < 0.001), lesions with low-grade histological features (p = 0.003), and tumor excision greater than 90% at surgery (p = 0.04). The perioperative morbidity and mortality rates were 37 and 4%, respectively. Fifty-four percent of the patients in this group had a long-term and independent survival. The thalamopeduncular tumors were mostly pilocytic astrocytomas, which had a good prognosis following surgery. The bilateral thalamic tumors in this series were mainly low-grade astrocytic lesions, and more than half of the children attained long-term survival (mean follow-up duration 4.5 years). Conclusions. The majority of tumors arising in the thalamus are astrocytic, of which less than half are high-grade lesions. Histological evaluations should be performed in all patients in whom resection is being considered for discrete lesions. Long-term survival is possible in patients with these tumors.
Affiliations:
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Crimmins</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurosurgery, Leeds General Infirmary</s1><s2>Leeds</s2><s3>GBR</s3><sZ>2 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Leeds</wicri:noRegion></affiliation></author><author><name sortKey="Garnett, Matthew R" sort="Garnett, Matthew R" uniqKey="Garnett M" first="Matthew R." last="Garnett">Matthew R. 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aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Hôpital Necker-Enfants Malades</wicri:noRegion><wicri:noRegion>Department of Neuroradiology, Hôpital Necker-Enfants Malades</wicri:noRegion></affiliation></author><author><name sortKey="Wray, Alison" sort="Wray, Alison" uniqKey="Wray A" first="Alison" last="Wray">Alison Wray</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Royal Children's Hospital</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>7 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Lelouch Tubiana, Arielle" sort="Lelouch Tubiana, Arielle" uniqKey="Lelouch Tubiana A" first="Arielle" last="Lelouch-Tubiana">Arielle Lelouch-Tubiana</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Neuropathology, Hôpital Necker-Enfants Malades</s1><s3>FRA</s3><sZ>8 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Hôpital Necker-Enfants Malades</wicri:noRegion><wicri:noRegion>Department of Neuropathology, Hôpital Necker-Enfants Malades</wicri:noRegion></affiliation></author><author><name sortKey="Roujeau, Thomas" sort="Roujeau, Thomas" uniqKey="Roujeau T" first="Thomas" last="Roujeau">Thomas Roujeau</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Hôpital Necker-Enfants Malades</wicri:noRegion><wicri:noRegion>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</wicri:noRegion></affiliation></author><author><name sortKey="Di Rocco, Federico" sort="Di Rocco, Federico" uniqKey="Di Rocco F" first="Federico" last="Di Rocco">Federico Di Rocco</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Hôpital Necker-Enfants Malades</wicri:noRegion><wicri:noRegion>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</wicri:noRegion></affiliation></author><author><name sortKey="Zerah, Michel" sort="Zerah, Michel" uniqKey="Zerah M" first="Michel" last="Zerah">Michel Zerah</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Hôpital Necker-Enfants Malades</wicri:noRegion><wicri:noRegion>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</wicri:noRegion></affiliation></author><author><name sortKey="Sainte Rose, Christian" sort="Sainte Rose, Christian" uniqKey="Sainte Rose C" first="Christian" last="Sainte-Rose">Christian Sainte-Rose</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Hôpital Necker-Enfants Malades</wicri:noRegion><wicri:noRegion>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">07-0238069</idno><date when="2007">2007</date><idno type="stanalyst">PASCAL 07-0238069 INIST</idno><idno type="RBID">Pascal:07-0238069</idno><idno type="wicri:Area/PascalFrancis/Corpus">003C47</idno><idno type="wicri:Area/PascalFrancis/Curation">002441</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">003594</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">003594</idno><idno type="wicri:Area/Main/Merge">009D06</idno><idno type="wicri:Area/Main/Curation">009318</idno><idno type="wicri:Area/Main/Exploration">009318</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Thalamic tumors in children : a reappraisal</title><author><name sortKey="Puget, Stephanie" sort="Puget, Stephanie" uniqKey="Puget S" first="Stephanie" last="Puget">Stephanie Puget</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Hôpital Necker-Enfants Malades</wicri:noRegion><wicri:noRegion>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</wicri:noRegion></affiliation></author><author><name sortKey="Crimmins, Darach W" sort="Crimmins, Darach W" uniqKey="Crimmins D" first="Darach W." last="Crimmins">Darach W. Crimmins</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurosurgery, Leeds General Infirmary</s1><s2>Leeds</s2><s3>GBR</s3><sZ>2 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Leeds</wicri:noRegion></affiliation></author><author><name sortKey="Garnett, Matthew R" sort="Garnett, Matthew R" uniqKey="Garnett M" first="Matthew R." last="Garnett">Matthew R. Garnett</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Hôpital Necker-Enfants Malades</wicri:noRegion><wicri:noRegion>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</wicri:noRegion></affiliation></author><author><name sortKey="Grill, Jacques" sort="Grill, Jacques" uniqKey="Grill J" first="Jacques" last="Grill">Jacques Grill</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Deparunent of Pediatric and Adolescent Oncology, Gustave Roussy Institute</s1><s2>Paris</s2><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Oliveira, Ricardo" sort="Oliveira, Ricardo" uniqKey="Oliveira R" first="Ricardo" last="Oliveira">Ricardo Oliveira</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Hôpital Necker-Enfants Malades</wicri:noRegion><wicri:noRegion>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</wicri:noRegion></affiliation></author><author><name sortKey="Boddaert, Nathalie" sort="Boddaert, Nathalie" uniqKey="Boddaert N" first="Nathalie" last="Boddaert">Nathalie Boddaert</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Neuroradiology, Hôpital Necker-Enfants Malades</s1><s3>FRA</s3><sZ>6 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Hôpital Necker-Enfants Malades</wicri:noRegion><wicri:noRegion>Department of Neuroradiology, Hôpital Necker-Enfants Malades</wicri:noRegion></affiliation></author><author><name sortKey="Wray, Alison" sort="Wray, Alison" uniqKey="Wray A" first="Alison" last="Wray">Alison Wray</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Royal Children's Hospital</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>7 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Lelouch Tubiana, Arielle" sort="Lelouch Tubiana, Arielle" uniqKey="Lelouch Tubiana A" first="Arielle" last="Lelouch-Tubiana">Arielle Lelouch-Tubiana</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Neuropathology, Hôpital Necker-Enfants Malades</s1><s3>FRA</s3><sZ>8 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Hôpital Necker-Enfants Malades</wicri:noRegion><wicri:noRegion>Department of Neuropathology, Hôpital Necker-Enfants Malades</wicri:noRegion></affiliation></author><author><name sortKey="Roujeau, Thomas" sort="Roujeau, Thomas" uniqKey="Roujeau T" first="Thomas" last="Roujeau">Thomas Roujeau</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Hôpital Necker-Enfants Malades</wicri:noRegion><wicri:noRegion>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</wicri:noRegion></affiliation></author><author><name sortKey="Di Rocco, Federico" sort="Di Rocco, Federico" uniqKey="Di Rocco F" first="Federico" last="Di Rocco">Federico Di Rocco</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Hôpital Necker-Enfants Malades</wicri:noRegion><wicri:noRegion>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</wicri:noRegion></affiliation></author><author><name sortKey="Zerah, Michel" sort="Zerah, Michel" uniqKey="Zerah M" first="Michel" last="Zerah">Michel Zerah</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Hôpital Necker-Enfants Malades</wicri:noRegion><wicri:noRegion>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</wicri:noRegion></affiliation></author><author><name sortKey="Sainte Rose, Christian" sort="Sainte Rose, Christian" uniqKey="Sainte Rose C" first="Christian" last="Sainte-Rose">Christian Sainte-Rose</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Hôpital Necker-Enfants Malades</wicri:noRegion><wicri:noRegion>Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Journal of neurosurgery. Pediatrics</title></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of neurosurgery. Pediatrics</title></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Child</term><term>Glioma</term><term>Tumor</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Tumeur</term><term>Gliome</term><term>Enfant</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Enfant</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Object Two to five percent of pediatric brain tumors are located in the thalamus. The optimal management for these tumors remains unclear. The aim of this study was to determine whether clinical and neuroimaging features could guide treatment, and to what extent these features, together with histological diagnosis and treatment modalities, influenced survival. Methods. The records of 69 children who presented with a thalamic tumor between 1989 and 2003 were retrospectively reviewed. Three groups of tumors were analyzed separately: 1) unilateral thalamic tumors (54 lesions): 2) thalamopeduncular tumors (six); and 3) bilateral thalamic tumors (nine). In the patients in whom a unilateral thalamic tumor was diagnosed, 33 had an astrocytic tumor. Of the 54 patients, 32 had a low-grade and 22 had a high-grade tumor. The survival rate was significantly better for patients with the following characteristics: symptom duration longer than 2 months (p < 0.001), lesions with low-grade histological features (p = 0.003), and tumor excision greater than 90% at surgery (p = 0.04). The perioperative morbidity and mortality rates were 37 and 4%, respectively. Fifty-four percent of the patients in this group had a long-term and independent survival. The thalamopeduncular tumors were mostly pilocytic astrocytomas, which had a good prognosis following surgery. The bilateral thalamic tumors in this series were mainly low-grade astrocytic lesions, and more than half of the children attained long-term survival (mean follow-up duration 4.5 years). Conclusions. The majority of tumors arising in the thalamus are astrocytic, of which less than half are high-grade lesions. Histological evaluations should be performed in all patients in whom resection is being considered for discrete lesions. Long-term survival is possible in patients with these tumors.</div></front></TEI><affiliations><list><country><li>Australie</li><li>France</li><li>Royaume-Uni</li></country><region><li>Victoria (État)</li><li>Île-de-France</li></region><settlement><li>Melbourne</li><li>Paris</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Puget, Stephanie" sort="Puget, Stephanie" uniqKey="Puget S" first="Stephanie" last="Puget">Stephanie Puget</name></noRegion><name sortKey="Boddaert, Nathalie" sort="Boddaert, Nathalie" uniqKey="Boddaert N" first="Nathalie" last="Boddaert">Nathalie Boddaert</name><name sortKey="Di Rocco, Federico" sort="Di Rocco, Federico" uniqKey="Di Rocco F" first="Federico" last="Di Rocco">Federico Di Rocco</name><name sortKey="Garnett, Matthew R" sort="Garnett, Matthew R" uniqKey="Garnett M" first="Matthew R." last="Garnett">Matthew R. Garnett</name><name sortKey="Grill, Jacques" sort="Grill, Jacques" uniqKey="Grill J" first="Jacques" last="Grill">Jacques Grill</name><name sortKey="Lelouch Tubiana, Arielle" sort="Lelouch Tubiana, Arielle" uniqKey="Lelouch Tubiana A" first="Arielle" last="Lelouch-Tubiana">Arielle Lelouch-Tubiana</name><name sortKey="Oliveira, Ricardo" sort="Oliveira, Ricardo" uniqKey="Oliveira R" first="Ricardo" last="Oliveira">Ricardo Oliveira</name><name sortKey="Roujeau, Thomas" sort="Roujeau, Thomas" uniqKey="Roujeau T" first="Thomas" last="Roujeau">Thomas Roujeau</name><name sortKey="Sainte Rose, Christian" sort="Sainte Rose, Christian" uniqKey="Sainte Rose C" first="Christian" last="Sainte-Rose">Christian Sainte-Rose</name><name sortKey="Zerah, Michel" sort="Zerah, Michel" uniqKey="Zerah M" first="Michel" last="Zerah">Michel Zerah</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Crimmins, Darach W" sort="Crimmins, Darach W" uniqKey="Crimmins D" first="Darach W." last="Crimmins">Darach W. Crimmins</name></noRegion></country><country name="Australie"><region name="Victoria (État)"><name sortKey="Wray, Alison" sort="Wray, Alison" uniqKey="Wray A" first="Alison" last="Wray">Alison Wray</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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