Is the Knowledge Pertaining to Adult Glioblastomas Enough for Pediatric Cases? Prognostic Factors in Childhood
AIM: Pediatric glioblastoma (GBM) is still a topic obscurity. The aim of this study was to explore clinical, radiological and pathological
features, and prognostic factors affecting the outcomes.
MATERIAL and METHODS: We retrospectively reviewed our database for prognostic factors for 42 consecutive pediatric patients
with histologically proven GBM treated in our hospital.
RESULTS: The study reached at 20 boys and 22 girls, with a mean age of 10.2 years. Almost all patients (97.6%) had supratentorial
tumors; lobar/hemispheric (68.3%), thalamic (26.8%) and suprasellar-hypothalamic region (4.8%). Total of 11/42 children had
seeding metastases (mean 11.5 months) either preoperatively or postoperatively. Gross total resection (GTR) was achieved in 13
patients (30.9%) in the first surgery. Perioperative mortality and morbidity rates were 4.7% and 19%, respectively. Patients were
followed for an average of 18.1 months. The median progression-free and overall survivals were 7.0 (95% CI: 5.9-8.0) and 11.0 (95%
CI: 8.9-13.1) months, respectively. 1-year, 2-year and 5-year progression-free survival and overall survivals were 30.9% vs. 50.0%,
11.9% vs. 19.0%, 4.8% vs. 9.5%; respectively.
CONCLUSION: Gross total resection should be safely attempted in pediatric GBM. In addition, a thorough and frequent radiological
evaluation of the entire neuraxis for seeding metastases is recommended both at diagnosis and follow-ups.