Volume 24, Number 12, 1447-1455, DOI: 10.1007/s00381-008-0692-7

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Outcome of children with low-grade cerebellar astrocytoma: long-term complications and quality of life

Tycho J. Zuzak, Andrea Poretti, Barbara Drexel, Daniel Zehnder, Eugen Boltshauser and Michael A. Grotzer

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Abstract

Objects  

To study the long-term outcome of surgically treated low-grade cerebellar astrocytomas in children.

Materials and methods  

We followed 31 consecutive patients under 16 years of age who were diagnosed between 1980 and 2005 in a single institution. In 21 of 31 survivors (median follow-up time 7.9 years; range 5.6–27.4 years) who agreed to participate, tumor control, neurological and cognitive complications, and their impact on behavioral and emotional adjustment and health-related quality of life (HRQoL) were comprehensively assessed qualitatively and quantitatively.

Results  

Neurological sequelae were found in 43%. However, age-appropriate ability to perform daily life activities was normal in all patients. Remarkably, cognitive deficits leading to significant school problems occurred in 19% and behavioral and emotional adjustment disturbances in 27%. In comparison with healthy controls, the survivors rated their HRQoL similarly or even higher.

Conclusion  

Childhood low-grade cerebellar astrocytomas have an excellent cure rate by tumor surgery alone. When compared with other pediatric brain tumors, the risk of neurological, cognitive, emotional, and behavioral complications is relatively small. HRQoL is similar to that of healthy controls.

Keywords  Brain neoplasm - Child - Astrocytoma - Outcome assessment - Quality of life

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