LGG-29. RESIDUAL TUMOUR SIZE AS A PREDICTOR OF PROGRESSION FOR PAEDIATRIC LOW-GRADE GLIOMA. Issue 2 (22nd June 2018)

• Record Type: Journal Article
• Authors: Ghosh, Neelakshi; Manias, Karen; Bennett, Christopher D; Oates, Adam; English, Martin; Peet, Andrew; Adamski, Jenny
• Is Part Of: Neuro-oncology. Volume 20:Issue 2(2018)supplement 2
• Page Start: i110
• Page End: i110
• Publication Date: 2018-06-22
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noy059.370
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: OBJECTIVE: Paediatric low-grade glioma can progress or recur following primary surgical/non-surgical treatment and require further therapy. Studies have identified clinical characteristics predictive of disease progression. This study aims to determine whether size of residual disease following primary treatment is a prognostic indicator for predicting progression. METHODS: A retrospective analysis of 61 children with histopathologically confirmed low-grade glioma treated at Birmingham Children's Hospital between 2004 and 2015 was performed. Residual tumour size following primary treatment was measured from MR imaging and analysed in context of clinical characteristics. RESULTS: 47.5% (29/61) children progressed during the follow-up period. A residual tumour size of ≤1cm 3 was predictive of better progression free survival for the entire cohort (p<0.001). Age at diagnosis (p=0.377), gender (p=0.619) and Ki-67 index (p=0.234) were not associated with tumour progression. Cerebellar tumours had a longer progression-free interval compared to supratentorial, midline tumours, including the hypothalamic optic pathway tumours (p=0.001). Children with larger residual disease (>2cm 3 ) progressed earlier (minimum 0.36 years) than those with smaller residuals (<2cm 3 ) (minimum 1.1 years). The majority (75.8%) of children with disease progression were asymptomatic and detected on surveillance imaging only. CONCLUSION: Asymptomatic disease progression occurs following primary treatment for low-grade glioma. Children with smaller residual disease are less likely to progress, with disease progression occurring later after initial treatment. Surveillance neuroimaging is needed to detect disease progression, and optimal timing of imaging may be tailored based on the size of residual disease.