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Medical, psychological, cognitive and educational late‐effects in pediatric low‐grade glioma survivors treated with surgery only
Author(s) -
Turner Christopher D.,
Chordas Christine A.,
Liptak Cori C.,
ReyCasserly Celiane,
Delaney Brian L.,
Ullrich Nicole J.,
Goumnerova Liliana C.,
Scott R. Michael,
Begley Heather C.,
Fletcher William J.,
Yao Xiaopan,
Chi Susan,
Kieran Mark W.
Publication year - 2009
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22081
Subject(s) - medicine , anxiety , pediatrics , depression (economics) , ataxia , population , suicidal ideation , surgery , psychiatry , injury prevention , poison control , emergency medicine , environmental health , economics , macroeconomics
Abstract Background Surgical resection is often the only treatment necessary for pediatric low‐grade gliomas (LGGs) and is thought to define a population with an excellent long‐term prognosis. The goal of this study was to describe the multidimensional late‐effects of pediatric LGG survivors treated exclusively with surgery. Methods A retrospective chart review of “surgery‐only” LGG survivors followed at Dana‐Farber/Children's Hospital Cancer Care was undertaken. Patients had to be diagnosed with an LGG before the age of 22 years, treated with “surgery‐only” and be at least 2 years from diagnosis. Results Sixty survivors were eligible with a median age at the time of review of 16.3 years and the median time since diagnosis of 8.4 years. Tumor locations were predominantly posterior fossa (47%) or cortical (33%). Eighty‐five percent of patients had at least one ongoing late‐effect, and 28% had three or more. The most common late‐effects consisted of motor dysfunction (43%), visual problems (32%), anxiety (19%), social difficulties (19%), seizure disorders (17%), depression (15%), poor coordination/ataxia (14%), behavioral problems (13%), and endocrinopathies (10%). Nine patients had a history of suicidal ideation; two with suicide attempts. The mean full‐scale IQ was normal, however, the number of survivors scoring one standard deviation below the mean was twice the expected number. Special education services were utilized by more than half of the survivors. Conclusions “Surgery‐only” LGG survivors may be more affected by their tumor and its resection than previously appreciated. A prospective study is needed to address this survivor population. Pediatr Blood Cancer 2009;53:417–423. © 2009 Wiley‐Liss, Inc.