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Duration between onset and diagnosis in central nervous system tumors: Impact on prognosis and functional outcome
Author(s) -
Fukuoka Kohei,
Yanagisawa Takaaki,
Suzuki Tomonari,
Shirahata Mitsuaki,
Adachi Junichi,
Mishima Kazuhiko,
Fujimaki Takamitsu,
Matsutani Masao,
Nishikawa Ryo
Publication year - 2014
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12369
Subject(s) - medicine , univariate analysis , central nervous system , multivariate analysis , grading (engineering) , neuroimaging , pediatrics , civil engineering , psychiatry , engineering
Background The initial presentation of central nervous system ( CNS ) tumors in children frequently mimics other more common and less serious conditions, resulting in diagnostic difficulty and a prolonged time to diagnosis. Yet whether early diagnosis contributes to better life prognosis and functional outcome has not been elucidated. Only a few such reports have originated from J apan, where neuroimaging techniques are the best in the world. We examined the time to diagnosis, the so‐called prediagnostic symptomatic interval ( PSI ), and its impact on prognosis and functional outcome in children with CNS tumors. Methods We reviewed the records of 127 patients aged <15 years with CNS tumors, who were treated at our two institutions between N ovember 1993 and O ctober 2011. Results The median age at diagnosis was 7.2 years (range, 3 weeks–14.9 years). The male‐to‐female ratio was 63:64. Median PSI was 1.5 months (0–36 months). Overall survival and progression‐free survival did not differ significantly between the groups, regardless of whether the PSI was longer than the median PSI . The PSI was significantly longer in patients with long‐lasting clinical signs after the initial treatment than in patients with temporary symptoms only at onset. Both univariate and multivariate analysis showed that high histological grading was statistically correlated with short PSI . Conclusions A short PSI was significantly associated with high‐grade tumors. Earlier diagnosis did not lead to better life prognosis, but possibly to better functional outcome in children with CNS tumors.