A single-center experience of central nervous system tumors in children under three years old.

IF 2.1 3区医学 Q2 PEDIATRICS Frontiers in Pediatrics Pub Date : 2024-12-18 eCollection Date: 2024-01-01 DOI:10.3389/fped.2024.1441016

Junhua Wang, Chuanwei Wang, Zhimin Huang, Zhihua Zhang, Yuqi Zhang

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Abstract

Purpose: This study aims to summarize the characteristics of children under three years old (≤3 years) with central nervous system (CNS) tumors and to investigate the factors that influence their overall survival (OS) time.

Methods: We treated 171 pediatric patients (≤3 years) with CNS tumors at Yuquan Hospital of Tsinghua University from January 2016 to June 2023. Of these, 162 cases were successfully followed up. Kaplan-Meier survival analysis and Cox regression were utilized to evaluate factors potentially influencing OS of malignancies.

Results: There was a male predominance among the patients. The three most common tumors were embryonal tumors, gliomas, and craniopharyngiomas. Gross total resection (GTR) was achieved in select cases. Patients with high-grade malignancies were advised to undergo chemotherapy and/or radiotherapy after surgery. Optic gliomas and diffuse midline gliomas were partially resected and treated with adjuvant treatments. The median survival time of low-grade malignant tumors was 41.5 months, while that of high-grade malignant tumors was 15 months. Kaplan-Meier survival analysis identified the factors potentially influencing OS of malignancies: extent of resection, CNS WHO grade, grade of malignancies, and Ki-67 labeling index (Ki-67 LI). Subsequent multivariate analysis highlighted the interactive factor (extent of resection × CNS WHO grade) along with Ki-67 LI, as the most significant variables. Factors such as sex, age, tumor location, and onset-to-treatment time appeared not to affect OS.

Conclusions: GTR remains the cornerstone of treatment for children (≤3 years) with CNS tumors, except for optic glioma, diffuse midline glioma, and germinoma. The interactive factor (extent of resection × CNS WHO grade) and Ki-67 LI are the most significant factors affecting OS. The implementation of preoperative neoadjuvant chemotherapy and early postoperative chemotherapy may enhance prognosis.

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三岁以下儿童中枢神经系统肿瘤的单中心研究。

目的：本研究旨在总结3岁以下（≤3岁）儿童中枢神经系统（CNS）肿瘤的特点，探讨影响其总生存期（OS）的因素。方法：2016年1月至2023年6月在清华大学玉泉医院治疗了171例（≤3岁）小儿中枢神经系统肿瘤患者。其中162例成功随访。采用Kaplan-Meier生存分析和Cox回归评价恶性肿瘤生存期的潜在影响因素。结果：患者以男性为主。最常见的三种肿瘤是胚胎瘤、胶质瘤和颅咽管瘤。在部分病例中实现了总全切除（GTR）。高度恶性肿瘤患者建议术后接受化疗和/或放疗。视神经胶质瘤和弥漫性中线胶质瘤部分切除并辅以辅助治疗。低级别恶性肿瘤的中位生存时间为41.5个月，高级别恶性肿瘤的中位生存时间为15个月。Kaplan-Meier生存分析确定了可能影响恶性肿瘤OS的因素：切除范围、CNS WHO分级、恶性肿瘤分级和Ki-67标记指数（Ki-67 LI）。随后的多变量分析强调了交互因素（切除程度× CNS WHO分级）和Ki-67 LI是最显著的变量。性别、年龄、肿瘤位置、发病至治疗时间等因素似乎不影响OS。结论：除视神经胶质瘤、弥漫性中线胶质瘤和生殖细胞瘤外，GTR仍然是儿童（≤3岁）中枢神经系统肿瘤治疗的基石。相互作用因子（切除范围× CNS WHO分级）和Ki-67 LI是影响OS的最显著因素。术前新辅助化疗及术后早期化疗可改善预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Pediatrics Medicine-Pediatrics, Perinatology and Child Health

CiteScore

3.60

自引率

7.70%

发文量

2132

审稿时长

14 weeks

期刊介绍： Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.