Primary spinal cord tumors of childhood: effects of clinical presentation, radiographic features, and pathology on survival
Crawford JR et al. - In a study to determine the relationship between clinical presentation, radiographic features, pathology, and treatment on overall survival of newly diagnosed pediatric primary spinal cord tumors (PSCT), it was reported that MRI homogeneous gadolinium enhancement patterns may be helpful in distinguishing low grade from high grade spinal cord malignancies. While tumor grade and gross total resection rather than duration of symptoms correlated with survival, greater than one-third of pts had reported symptoms of >6 mos duration prior to diagnosis. Methods- Retrospective analysis of all previously healthy children with newly diagnosed PSCT at a single institution from 1995 to present was performed.
Results- 25 pediatric pts (15 boys, average 7.9 yrs) were diagnosed with PSCT.
- Presenting symptoms ranged from 0.25 to 60 mos (average 7.8 mos).
- Symptom duration was significantly shorter for high-grade tumors (average 1.65 mos) than low-grade tumors (average 11.2 mos).
- MRI revealed tumor (8 cervical, 17 thoracic, 7 lumbar, 7 sacral) volumes of 98–94,080 mm3 (average 19,474 mm3).
- Homogeneous gadolinium enhancement on MRI correlated with lower grade pathology.
- There was no correlation between tumor grade and volume or edema by MRI analysis.
- Median survival was 53 mos and was dependent on tumor grade and gross total resection, but not on gender, age of presentation, duration of presenting symptoms, or adjuvant therapies.
- Stratified Kaplan–Meier analysis confirmed the association between degree of resection and survival after controlling for tumor grade.
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