HEMISPHERIC CEREBRAL-TUMORS IN CHILDREN - LONG-TERM PROGNOSIS CONCERNING SURVIVAL RATE AND QUALITY OF LIFE - CONSIDERATIONS ON A SERIES OF 64 CASES OPERATED UPON

A series of 64 consecutive cases of children with neuroepthelial tumors of the cerebral hemispheres operated on from 1966 to 1983 is analyzed with regard to the long-term survival rate and the quality of life at late follow-up. At the time of the diagnosis the age of the patients ranged from 8 months to 15 years (mean age 7.6 years), and the relative incidence of these neoplasms was found to be about the same (37%) in the subgroups from 5 to 10 years and 11 to 15 years. It was only 9% in patients below 2 years of age. Tumor removal was radical in 84% and partial in 16% of the cases. The overall operative mortality was 14%, although it has been 4% since 1977. At histology, grade I and II lesions were found to account for 70% of the cases, and of the remaining 30% of the cases 8% were grade IV anaplastic lesions. The survival rate of the 55 survivors was calculated according to the actuarial life-table analysis. It was 62% at 5 years and 40% at 15 years. The survival rate at 5 years was 80% for low grade (I and II) tumors while it was 25% for high-grade malignancy (III-IV) tumors. The quality of life was assessed in all 29 patients with long-term survival (disease-free state lasting for at least 5 years) by adopting a specific protocol, which included repeated CT studies and neuropsychological evaluation. A more favorable prognosis was established for children operated on when over 6 years of age and with frontal and parietal neoplasms, while a poor functional prognosis was observed in children below 6 years of age and with temporal lobe tumors. © 1990 Springer-Verlag.