Incidence and long term survival of children with intracranial tumours treated in Denmark 1935-1959

Abstract

Summary.-The total number of children under 15 years of age with intracranial tumours in Denmark during the years 1935-1959 was found to be 533. The average incidence was 21 new cases/106 children/year during the 25-year period in question, and 25/106 children/year during the first 17 years of Danish cancer registration. The sex ratio (290 boys to 243 girls) was not significantly different from that of the child population in Denmark. In 219 cases the tumour was located in the supratentorial and in 314 in the infratentorial space. 9300 of the tumours were histologically verified, with the following order of frequency for the most usual types: astrocytomas (all grades), medulloblastomas, ependymomas, and craniopharyngiomas. Follow-up was 1000%. For the 345 children who survived for more than one month after operation or diagnosis, 36% were alive after 15 years. 119 patients were alive in April 1974 and these were all observed between 15-40 years after diagnosis and operation. Of these 44 had tumours in the supratentorial and 75 in the infratentorial space. 660/" of the survivors with supratentorial and 9000 with infratentorial tumours led a normal life.Most of the survivors had had a cerebellar astrocytoma, a supratentorial astrocytoma, an apendymoma or oligodendroglioma, but other histological diagnoses were also represented, especially in the supratentorial group. The long-term prognosis was especially bad for children with brain-stem tumours, infratentorial ependymomas and medulloblastomas.

Re-Operation for Recurrent Brain Tumors in Children

“…Part of the difficulty in answering these questions lies in the fact that there is little consistency in the literature in the methods of reporting survival after tumor diagnosis. The various reports include overall survival of all tumors [1,7,8,11], survival of supratentorial versus infratentorial tumors [7], survival by area of brain involved [6], and survival by indi vidual tumor type [1-9, 11-20. 23, 26], The reports of survival by individual tumor types are most useful for comparing our results; however, even this literature is confused by varying statistical techniques such as reporting by 1, 3. or 5 years and higher, survivals, by giving median survivals of tumor types, or by reporting median times to relapse.…”

“…Brain tumors follow leukemia as the second most common type of neoplasm [8,10,II] with an incidence of about 2.4 per 100,000 per year [7,8,11], Standard therapies for previously untreated tumor include surgery, radi ation therapy, and more recently, chemotherapy, including steroids, which have been in common use for the last 3 decades. For recurrent tumors, radiation, if tolerated, and chemotherapy are the most commonly employed treatment modalities.…”

Atherosclerotic Disease of the Aortic Arch and the Risk of Ischemic Stroke

“…3 The objective criteria by which histologic features are used to make diagnoses may be applied inconsistently 3 or interpreted by different observers in the same 4,5 or separate data bases. 4,6,7 The histologic appearance of childhood brain tumors is often heterogeneous, suggesting very different tumors within the same specimen 3 -a characteristic that makes efforts to categorize such tumors according to standard World Health Organization (WHO) criteria 8 problematic. WHO histologic criteria may be applicable to more than one diagnosis; in one study, the histologic criteria for as many as four disparate tumors were similar.…”

Recurrent Brain Tumors in Children

“…Neoplasms which occur intrinsically within the brain stem are almost exclusively astrocytic in origin, and demonstrate the poorest outcome of any pediatric brain tumor [1]. The surgeon is limited because of the infiltra tive nature of the lesion into the surrounding vital struc tures.…”

“…In a population-based study in Denmark encompassing several decades the incidence of intracranial neoplasms was estimated at 21 new patients less than 15 years of age/100,000 children/year [1], This combined with the observation that 36% of operative survivors were alive 15 years following diagnosis [1] will quickly lead to the conclusion that most children diagnosed with a brain tumor will present at some time with clinical evidence of recurrence. The likelihood of recurrence is multifactori al.…”