Thalamic tumors in children : a reappraisal
Identifieur interne : 002441 ( PascalFrancis/Curation ); précédent : 002440; suivant : 002442Thalamic 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
Descripteurs français
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.
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<author><name sortKey="Sainte Rose, Christian" sort="Sainte Rose, Christian" uniqKey="Sainte Rose C" first="Christian" last="Sainte-Rose">Christian Sainte-Rose</name>
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<term>Glioma</term>
<term>Tumor</term>
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<term>Gliome</term>
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<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>
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<fA08 i1="01" i2="1" l="ENG"><s1>Thalamic tumors in children : a reappraisal</s1>
</fA08>
<fA11 i1="01" i2="1"><s1>PUGET (Stephanie)</s1>
</fA11>
<fA11 i1="02" i2="1"><s1>CRIMMINS (Darach W.)</s1>
</fA11>
<fA11 i1="03" i2="1"><s1>GARNETT (Matthew R.)</s1>
</fA11>
<fA11 i1="04" i2="1"><s1>GRILL (Jacques)</s1>
</fA11>
<fA11 i1="05" i2="1"><s1>OLIVEIRA (Ricardo)</s1>
</fA11>
<fA11 i1="06" i2="1"><s1>BODDAERT (Nathalie)</s1>
</fA11>
<fA11 i1="07" i2="1"><s1>WRAY (Alison)</s1>
</fA11>
<fA11 i1="08" i2="1"><s1>LELOUCH-TUBIANA (Arielle)</s1>
</fA11>
<fA11 i1="09" i2="1"><s1>ROUJEAU (Thomas)</s1>
</fA11>
<fA11 i1="10" i2="1"><s1>DI ROCCO (Federico)</s1>
</fA11>
<fA11 i1="11" i2="1"><s1>ZERAH (Michel)</s1>
</fA11>
<fA11 i1="12" i2="1"><s1>SAINTE-ROSE (Christian)</s1>
</fA11>
<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>
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<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</fA14>
<fA14 i1="02"><s1>Department of Neurosurgery, Leeds General Infirmary</s1>
<s2>Leeds</s2>
<s3>GBR</s3>
<sZ>2 aut.</sZ>
</fA14>
<fA14 i1="03"><s1>Deparunent of Pediatric and Adolescent Oncology, Gustave Roussy Institute</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>4 aut.</sZ>
</fA14>
<fA14 i1="04"><s1>Department of Neuroradiology, Hôpital Necker-Enfants Malades</s1>
<s3>FRA</s3>
<sZ>6 aut.</sZ>
</fA14>
<fA14 i1="05"><s1>Royal Children's Hospital</s1>
<s2>Melbourne</s2>
<s3>AUS</s3>
<sZ>7 aut.</sZ>
</fA14>
<fA14 i1="06"><s1>Department of Neuropathology, Hôpital Necker-Enfants Malades</s1>
<s3>FRA</s3>
<sZ>8 aut.</sZ>
</fA14>
<fA20><s1>354-362</s1>
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<fC01 i1="01" l="ENG"><s0>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.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B25J</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE"><s0>Tumeur</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG"><s0>Tumor</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA"><s0>Tumor</s0>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE"><s0>Gliome</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG"><s0>Glioma</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA"><s0>Glioma</s0>
<s5>02</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE"><s0>Enfant</s0>
<s5>09</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG"><s0>Child</s0>
<s5>09</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA"><s0>Niño</s0>
<s5>09</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Homme</s0>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Human</s0>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Hombre</s0>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Système nerveux central pathologie</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Central nervous system disease</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0>
<s5>37</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Système nerveux pathologie</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Nervous system diseases</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Sistema nervioso patología</s0>
<s5>38</s5>
</fC07>
<fN21><s1>162</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
</fN82>
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