Ncmp-06. Neurological Outcome in Pediatric Cervicomedullary Tumors
Year: 2017
Type: conference-abstract
Abstract: We present neurological outcomes in pediatric cervicomedullary tumors (CMT). We retrospectively examined neurological outcomes in pediatric CMT from 1998-2015. Neurological severity was measured using National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 for 11 deficits, Modified Rankin Scale (MRS), and Karnofsky Performance Score (KPS). The data were analyzed using descriptive statistical methods and plots. Thirty-six patients (50% male), median age at cancer diagnosis 7.7 (0.6-17.8) years had median time to last follow-up 6.2 (0.4-26) years. Tumor pathology varied (25% pilocytic astrocytoma, 25% ganglioglioma, 16.7% astrocytoma, 2.8% myxopapillary ependymoma, 2.8% anaplastic ependymoma, 5.6% anaplastic astrocytoma, 5.6 ependymoma, 5.6% glioblastoma multiforme, and 10.9% other). Thirty-five patients had one surgery (11 biopsy, 2 gross total resection, 19 subtotal resection, 3 biopsy plus subtotal resection). Eleven patients had 2 or more surgeries, 12 had chemotherapy, and 24 had radiotherapy. Median MRS was 2 pre-operative, 2 post-operative, and 1.5 at 5 year follow-up (±2.5 years). Median KPS was 80 pre-operative, 80 post-operative, and 85 at 5 year follow-up. Pre-operative deficits were 62.9% motor weakness, 18.5% ataxia/dysmetria, 18.5% movement, 11.4% vocal cord paralysis, 11.4% autonomic, 11.1% sensory, 11.1% facial motor/sensory, 8.6% sleep, and 3.7% oculomotor. Post-operative deficits were 54.8% motor weakness, 29.0% movement, 29.0% ataxia/dysmetria, 22.9% autonomic, 19.4% sensory, 15.6% oculomotor, 12.9% facial motor/sensory, 5.7% sleep, and 3.2% urinary/gastrointestinal. Deficits at 5-year follow-up were 45.8% movement, 41.7% motor weakness, 41.7% ataxia/dysmetria, 20.8% sleep, 16.7% facial sensory/motor, 12.5% hearing loss, 12.5% autonomic, 8.3% vocal cord paralysis, 4.2% hiccups, 4.2% oculomotor, and 4.2% sensory. The majority of deficits were mild to moderate at each time point. Pediatric CMT after surgery may have long-term neurological deficits, most commonly movement disorder, motor weakness, and ataxia/dysmetria. Less common deficits to monitor for are singulitis, vocal cord paralysis, sleep disorder, and autonomic dysfunction.
Source: Neuro-Oncology
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2768057995