Clinical profile, treatment and outcome of pediatric brain tumors in Serbia in a 10-year period: A national referral institution experience

<h4>Objective</h4> This study aimed to evaluate the characteristics of children with primary brain tumors, the effectiveness of treatment modalities, and to detect factors related to the outcome. <h4>Methods</h4> A detailed analysis was performed on a series of 173 pediatric...

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Autores principales: Dragana Stanić, Danica Grujičić, Tatjana Pekmezović, Jelena Bokun, Marija Popović-Vuković, Dragana Janić, Lejla Paripović, Vesna Ilić, Marija Pudrlja Slović, Rosanda Ilić, Savo Raičević, Milan Sarić, Ivana Mišković, Borko Nidžović, Marina Nikitović
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spelling oai:doaj.org-article:117c0a34c6764030ad04c41d4985a0a62021-11-04T06:19:42ZClinical profile, treatment and outcome of pediatric brain tumors in Serbia in a 10-year period: A national referral institution experience1932-6203https://doaj.org/article/117c0a34c6764030ad04c41d4985a0a62021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8547703/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4> This study aimed to evaluate the characteristics of children with primary brain tumors, the effectiveness of treatment modalities, and to detect factors related to the outcome. <h4>Methods</h4> A detailed analysis was performed on a series of 173 pediatric patients treated in a Serbian referral oncology institution between 2007 and 2016, based on their clinical, histological, treatment, and follow-up data. <h4>Results</h4> Mean survival time of all children was 94.5months. 2-, 5- and 10-year overall survival probabilities were 68.8%, 59.4%, and 52.8%, respectively. Patients with supratentorial tumors had longer survival than patients with infratentorial tumors and patients with tumors in both compartments (p = 0.011). Children with the unknown histopathology (brainstem glioma) and high-grade glioma had a shorter life than embryonal tumors, ependymoma, and low-grade glioma (p<0.001). Survival of the children who underwent gross total resection was longer than the children in whom lesser degrees of resection were achieved (p = 0.015). The extent of the disease is a very important parameter found to be associated with survival. Patients with no evidence of disease after surgery had a mean survival of 123 months, compared with 82 months in patients with local residual disease and 55 months in patients with disseminated disease (p<0.001). By the univariate analysis, factors predicting poor outcome in our series were the presentation of disease with hormonal abnormalities, tumor location, and the extent of the disease, while the factors predicting a better outcome were age at the time of diagnosis, presentation of the disease with neurological deficit, and type of resection. By the multivariate analysis, the extent of the disease remained as the only strong adverse risk factor for survival (HR 2.06; 95% CI = 1.38–3.07; p<0.001). <h4>Conclusions</h4> With an organized and dedicated multidisciplinary team, the adequate outcomes can be achieved in a middle-income country setting. The presence of local residual disease after surgery and disseminated disease has a strong negative effect on survival.Dragana StanićDanica GrujičićTatjana PekmezovićJelena BokunMarija Popović-VukovićDragana JanićLejla ParipovićVesna IlićMarija Pudrlja SlovićRosanda IlićSavo RaičevićMilan SarićIvana MiškovićBorko NidžovićMarina NikitovićPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Dragana Stanić
Danica Grujičić
Tatjana Pekmezović
Jelena Bokun
Marija Popović-Vuković
Dragana Janić
Lejla Paripović
Vesna Ilić
Marija Pudrlja Slović
Rosanda Ilić
Savo Raičević
Milan Sarić
Ivana Mišković
Borko Nidžović
Marina Nikitović
Clinical profile, treatment and outcome of pediatric brain tumors in Serbia in a 10-year period: A national referral institution experience
description <h4>Objective</h4> This study aimed to evaluate the characteristics of children with primary brain tumors, the effectiveness of treatment modalities, and to detect factors related to the outcome. <h4>Methods</h4> A detailed analysis was performed on a series of 173 pediatric patients treated in a Serbian referral oncology institution between 2007 and 2016, based on their clinical, histological, treatment, and follow-up data. <h4>Results</h4> Mean survival time of all children was 94.5months. 2-, 5- and 10-year overall survival probabilities were 68.8%, 59.4%, and 52.8%, respectively. Patients with supratentorial tumors had longer survival than patients with infratentorial tumors and patients with tumors in both compartments (p = 0.011). Children with the unknown histopathology (brainstem glioma) and high-grade glioma had a shorter life than embryonal tumors, ependymoma, and low-grade glioma (p<0.001). Survival of the children who underwent gross total resection was longer than the children in whom lesser degrees of resection were achieved (p = 0.015). The extent of the disease is a very important parameter found to be associated with survival. Patients with no evidence of disease after surgery had a mean survival of 123 months, compared with 82 months in patients with local residual disease and 55 months in patients with disseminated disease (p<0.001). By the univariate analysis, factors predicting poor outcome in our series were the presentation of disease with hormonal abnormalities, tumor location, and the extent of the disease, while the factors predicting a better outcome were age at the time of diagnosis, presentation of the disease with neurological deficit, and type of resection. By the multivariate analysis, the extent of the disease remained as the only strong adverse risk factor for survival (HR 2.06; 95% CI = 1.38–3.07; p<0.001). <h4>Conclusions</h4> With an organized and dedicated multidisciplinary team, the adequate outcomes can be achieved in a middle-income country setting. The presence of local residual disease after surgery and disseminated disease has a strong negative effect on survival.
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author Dragana Stanić
Danica Grujičić
Tatjana Pekmezović
Jelena Bokun
Marija Popović-Vuković
Dragana Janić
Lejla Paripović
Vesna Ilić
Marija Pudrlja Slović
Rosanda Ilić
Savo Raičević
Milan Sarić
Ivana Mišković
Borko Nidžović
Marina Nikitović
author_facet Dragana Stanić
Danica Grujičić
Tatjana Pekmezović
Jelena Bokun
Marija Popović-Vuković
Dragana Janić
Lejla Paripović
Vesna Ilić
Marija Pudrlja Slović
Rosanda Ilić
Savo Raičević
Milan Sarić
Ivana Mišković
Borko Nidžović
Marina Nikitović
author_sort Dragana Stanić
title Clinical profile, treatment and outcome of pediatric brain tumors in Serbia in a 10-year period: A national referral institution experience
title_short Clinical profile, treatment and outcome of pediatric brain tumors in Serbia in a 10-year period: A national referral institution experience
title_full Clinical profile, treatment and outcome of pediatric brain tumors in Serbia in a 10-year period: A national referral institution experience
title_fullStr Clinical profile, treatment and outcome of pediatric brain tumors in Serbia in a 10-year period: A national referral institution experience
title_full_unstemmed Clinical profile, treatment and outcome of pediatric brain tumors in Serbia in a 10-year period: A national referral institution experience
title_sort clinical profile, treatment and outcome of pediatric brain tumors in serbia in a 10-year period: a national referral institution experience
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/117c0a34c6764030ad04c41d4985a0a6
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