Features of surgical treatment of cerebellar astrocytomas in children of the first years of life

Abstract

Introduction: Astrocytomas make up to 30-50% of all brain tumors in children and remains one of the actual problems of pediatric neurosurgery. Objective: To conduct a retrospective analysis of the treatment of cerebellar astrocytomas in children of early age during 30 years, to identify the factors determining the prognosis of the disease. Materials and methods: Results of treatment of 83 children of early age, operated for astrocytomas of cerebellum in the Pediatric Department in 1980-2009 years were analyzed. Male patients were 48 (57.8%), female — 35 (41.2%). Benign astrocytomas are diagnosed in 67 (80.7%) cases and malignant in 16 (19.3%). Astrocytoma of the cerebellum in 43 (51.8%) children contained a cystic component. Postoperative mortality over a 30-year period was 15.8%. Catamnesis was analyzed in 65 patients in terms in average 6.1 years. The evaluation of quality of life was based on a scale Yu.A. Orlov (2007). Results: The total removing of the tumor was done in 61.9% of patients, subtotal in 26.3%, partial in 11.8%, biopsies of tumours in 1.2%. Shunt surgery complement the removing of tumors in 40.8% cases. Postoperative mortality rate decreased from 18.2% in 1980-1989. to 6.7% in 2000-2009. In 1980-1989 years total removal was in 35.4%, in 2000-2009 in 66.7%. Survival at 1 year after operation was in 93.8%, 2 years – in 86.1%, 5 years – in 67.7% of cases. The good quality of life was noted in 21 (32.3%) of the children, satisfactory in 35 (53.8%), poor in 7 (10.8%) and the vegetative state in 2 (3.1%) children. Conclusions: The amount of removal of the tumor, the degree of malignancy, presence of cystic components affect the quality and duration of life of children of early age with cerebellar astrocytomas.