Complete removal is the treatment standard for most brain tumors. Outcomes of subsequent comprehensive treatment depend on biological features, the histological structure of the tumor, and radicality of surgery. The aim of this work was to study the morphological features of brain tumors in infants and to analyze long-term outcomes of surgical and comprehensive treatment.
Material and methods: The study included 80 infants with brain tumors aged from 1 to 12 months who had been operated on at the Burdenko Neurosurgical Institute during the period from 2000 to 2010.
Results: Maximal radicality was achieved in the group of tumors of the lateral and third ventricles (85%), in the group of tumors of hemispheric localization (82%), and in the group of tumors of the posterior fossa (83%). The lowest percentage of radical tumor removal (15%) accrued to tumors of the chiasmosellar area, most of which were large visual pathway gliomas. The overall five-year survival rate associated with the treatment in the studied series of patients was 92 and 48% for Grade I-II and Grade III-IV tumors, respectively.
Conclusion: The features of biology of brain tumors in infants include the increased proliferative activity (high Ki-67 index of 10% and higher) revealed at the diagnosis of choroid papillomas, a series of pilocytic astrocytomas of the chiasm and Grade III astrocytomas, which do not affect the clinical course. The best long-term results of the treatment were obtained in infants with complete resection of Grade I and III astrocytomas and in infants with choroid papillomas. Radical removal of such histological forms as anaplastic astrocytoma, choroidal carcinoma, and anaplastic ependymoma improves the prognosis, provides favorable conditions for adjuvant therapy, and increases the period of progression-free survival in infants.