Long-Term Neurological Outcome of Childhood Brain Tumors Treated by Surgery Only

Sønderkær, Signe; Schmiegelow, Marianne; Carstensen, Helena; Nielsen, Lars B.; Müller, Jørn; Schmiegelow, Kjeld

doi:10.1200/jco.2003.08.009

Cited by 68 publications

(56 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…17 Sønderkaer et al reported 69% of patients with brain tumors had a neurological deficit approximately 10 years from treatment, and using the Bloom's score, which closely mirrors aspects of the PCPC score, they estimated 23% had moderate disability and 2% had severe disability. 27 The similarities among cognitive outcomes were consistent despite variation in length of follow-up and measures of outcome (i.e., Bloom's score, intellectual quotient, and parent/patient questionnaire). 16 (12) 20 (20) 27 (42) 8 (62) 1 (100) 0 <0.001…”

Section: Discussionmentioning

confidence: 89%

“…1,7,17,21,22,27,32 Macedoni-Luksic et al reported 62% of children with brain tumors had at least 1 neurological impairment, with 22% moderately disabled and 2% severely disabled more than 3 years after treatment. 17 Sønderkaer et al reported 69% of patients with brain tumors had a neurological deficit approximately 10 years from treatment, and using the Bloom's score, which closely mirrors aspects of the PCPC score, they estimated 23% had moderate disability and 2% had severe disability.…”

Section: Discussionmentioning

confidence: 99%

“…10 The PCPC score mirrors measurements contained in the Bloom's score used for brain tumor survivors. 21,27 We assessed cognitive function at initial hospital discharge with the PCPC score, which enabled assessment of all patients and limited the number of confounding factors, such as radiation, chemotherapy, and reoperations associated with worsened outcome with later followup. 1,9,14,16,21 Both tumor progression and additional therapies (i.e., cranial radiation) cause cognitive dysfunction 8 (6) 9 (9) 7 (11) 5 (38) 1 ( with later onset and progression over time.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Hyponatremia and poor cognitive outcome following pediatric brain tumor surgery

Williams

Riva-Cambrin²,

Presson³

et al. 2015

PED

View full text Add to dashboard Cite

OBJECT Pediatric intracranial neoplasms are common and cause substantial neurological morbidity. Postoperative hyponatremia is also common and may exacerbate neurological injury. The authors performed an exploratory analysis to evaluate an exposure-response relationship between hyponatremia severity and cognitive function at discharge. METHODS A retrospective cohort of patients 0–19 years old who underwent a first intracranial neoplasm surgery at a pediatric tertiary care hospital was reviewed. Outcome was assessed by Pediatric Cerebral Performance Category (PCPC) score of 1–6 at hospital discharge. Poor outcome was defined as PCPC score 3–6, corresponding to moderate or worse disability. RESULTS Of 319 total children, 80 (25%) had poor outcomes. One hundred thirty-seven children (43%) had serum sodium concentrations ≤ 131–135 mEq/L and 39 (12%) had serum sodium concentrations ≤ 130 mEq/L. Lower nadir sodium concentration and longer duration of hyponatremia were significantly associated with worsening PCPC score (p < 0.001). Rapid sodium decreases and more hyponatremic episodes were also significantly associated with worsening PCPC score (p < 0.001). After adjustment for patient factors, tumor characteristics, and measures of sodium disruption, multivariable analysis revealed noncortical tumor locations and lower nadir sodium concentration (adjusted odds ratio 0.86, 95% confidence interval 0.78–0.95) were important independent risk factors for poor cognitive outcome. CONCLUSIONS Neurocognitive disability and hyponatremia are common in children undergoing surgery for intracranial neoplasms. This study found a significant association between severity of hyponatremia and worsened cognitive outcome, with an apparent exposure-response relationship. These data support the need for careful postoperative monitoring of serum sodium. Further research is needed to determine if prevention and treatment of hyponatremia can improve outcomes in these children.

show abstract

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hyponatremia and poor cognitive outcome following pediatric brain tumor surgery

Williams

Riva-Cambrin²,

Presson³

et al. 2015

PED

View full text Add to dashboard Cite

show abstract

“…As children who survive brain tumours face the risk of late neurocognitive deficits 10, 11, 12, as well as endocrine 4 and neurological 3 dysfunctions, the psychological burden on the children, parents and the whole family is great. The child's cognitive problems must also be recognised early and taken into consideration when planning the child's schooling 13, 14.…”

Section: Introductionmentioning

confidence: 99%

Multiprofessional follow‐up programmes are needed to address psychosocial, neurocognitive and educational issues in children with brain tumours

et al. 2015

View full text Add to dashboard Cite

AimThe aim of this study was to coordinate the structured psychosocial, neurocognitive and educational follow‐up of children treated for brain tumours with the medical protocol and apply the model in two Swedish healthcare regions.MethodsWe invited all children living in the two regions, who had been diagnosed with a brain tumour from October 1, 2010, through June 30, 2012, to participate along with their parents. The follow‐up programme evaluated the emotional status of the parents and patients and assessed the children's general cognitive level, working memory, speed of performance, executive functions and academic achievement from diagnosis through to adult care.ResultsDuring the study period, 61 children up to the age of 17.1 years were diagnosed with a brain tumour, but 18 of these were excluded for various reasons. The majority of the mothers (70%) displayed significantly poor emotional status, as did 34% of the fathers and 21% of the children. The majority of the children (57%) also showed poor neurocognitive performance and needed special adaptations at school (66%).ConclusionOur findings indicate the need for coordinated, multiprofessional follow‐up programmes, well anchored in the healthcare organisation, for children diagnosed with brain tumours

show abstract

“…The three remaining studies [117,227,228] involved a high proportion of non-neoplastic lesions that were not analyzed distinctly from neoplastic cases. Mean seizure free rates across the three studies ranged from a low of 56% to a high of 81%, with seizure improvement noted in 81.3% and 92.4% in the two studies in which this outcome was reported [117,227].…”

Section: The Benefits and Risks Of Surgerymentioning

confidence: 99%

Seizures in Children with Brain Tumours — Epidemiology, Significance, Management, and Outcomes

Ranger¹,

Diosy²

2015

Molecular Considerations and Evolving Surgical Management Issues in the Treatment of Patients With a Brain Tumor

View full text Add to dashboard Cite

Long-Term Neurological Outcome of Childhood Brain Tumors Treated by Surgery Only

Abstract: In patients who received operation as the only treatment for their brain tumor, there was a good chance of total or partial recovery of preoperative and postoperative neurological deficits, although only one third of the patients will have no long-term neurological deficits.

Cited by 68 publications

References 28 publications

Hyponatremia and poor cognitive outcome following pediatric brain tumor surgery

Hyponatremia and poor cognitive outcome following pediatric brain tumor surgery

Multiprofessional follow‐up programmes are needed to address psychosocial, neurocognitive and educational issues in children with brain tumours

Seizures in Children with Brain Tumours — Epidemiology, Significance, Management, and Outcomes

Contact Info

Product

Resources

About